Medicaid provides health insurance for millions of low-income, disabled and elderly Americans. While all 50 states participate in the federal program, eligibility requirements vary by state.
Thirty-one states have expanded Medicaid coverage to insure additional patients under the Patient Protection and Affordable Care Act (ACA). In states that have expanded coverage, Medicaid eligibility is available to individuals reporting incomes up to 138 percent of the federal poverty level, which varies depending on the size of a household. For a family of three, the 2017 federal poverty level was $20,420.
Of the states adopting Medicaid expansion, some have done so via Section 1115 waivers. They include Arizona, Arkansas, Indiana, Iowa, Michigan, Montana and New Hampshire.
Following the failure of the Republican-controlled Congress to overhaul the ACA, lawmakers in several states expressed interest in expanding coverage. New attempts to expand Medicaid coverage remain viable in at least three states: Georgia, Maine and North Carolina.
The Kansas state legislature voted to expand coverage in March, but Gov. Sam Brownback vetoed the bill. Republican-controlled legislatures in Missouri, Virginia and Wyoming similarly rejected Medicaid expansion proposals earlier this year.
The following map tracks the status of Medicaid expansion in each state:
||No Medicaid Expansion||
||Adopted Medicaid Expansion||
||Considering Medicaid Expansion|
The issue has come to a head in Wyoming, where rugged terrain and long distances between hospitals forces reliance on these ambulance flights.
More than 200 emails sent to an unstaffed office at the Kansas Department of Health and Environment were ignored.
Like Medicaid programs in many states that want more budgeting certainty or hope to save money, Medi-Cal is shifting many patients with complex conditions into managed care plans.