Low-income adults who qualify for expanded Medicaid under the Affordable Care Act (ACA) but live in states that have not increased eligibility for the program are at risk of paying higher out-of-pocket costs and receiving less comprehensive insurance coverage, according to a new Commonwealth Fund study. So far, 19 states have declined to expand their Medicaid programs.
Focusing on people earning between 100 percent and 138 percent of the federal poverty level, a population that is eligible for subsidized coverage in the ACA’s marketplaces, Commonwealth Fund researchers Sophie Beutel, Munira Gunja, and Sara Collins find that traditional Medicaid generally offers greater financial protection for low-income people than marketplace plans in three major areas: the cost of premiums, the number of benefits covered, and overall limits on out-of-pocket spending.