Obamacare/ACA Basics
Technically, Obamacare is just a nickname for theAffordable Care Act (ACA).
The ACA’s individual/family subsidy provisions were enhanced by the American Rescue Plan.
And some of those subsidy enhancements have been extended through 2025 by theInflation Reduction Act.
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That changed as of April 2023, and millions of people have since been disenrolled from Medicaid.
Obamacare health plans are not run by the government but must comply with various state and federal government regulations.
Those plans provide Medicaid benefits via a contract with state governments.
For several years, subsidy eligibility had an income cap equal to 400% of the federal poverty level.
But thatincome cap was temporarily eliminated by the American Rescue Plan.
And the Inflation Reduction Act extended that provision through 2025.
This can sometimes be the case for younger applicants in areas where health insurance is less expensive.)
Who Can Get Medicaid Coverage
To be eligible for Medicaid, you must have a low income.
However, a Supreme Court decision made it optional for states to comply with this part of the ACA.
Coverage gap:As of 2024, 10 states have not expanded Medicaid coverage to this group.
The state hasn’t expanded Medicaid but provides Medicaid to residents with income up to the poverty level.
As of July 2023, Georgia partially expanded Medicaid, but with a work requirement.
If you live in astatewithoutexpanded Medicaid coverage, youll have to meet the older, stricter eligibility criteria.
However, when you’re accepted into the Medicaid program, there is no waiting period.
Coverage takes effect immediately, or even retroactively.
But depending on the circumstances and where you live, Medicaid coverage can be retroactive.
On the other hand, Obamacare health plans often come with substantial deductibles, copayments, and coinsurance.
In fact, theres even a name for people who have both: dual eligibles.
More than 12 million Americans who receive coverage under both Medicare and Medicaid.
However, there’s usually no benefit to having both an Obamacare health insurance plan and Medicare.
It’s generally advised that you drop individual coverage under Obamacare once you’re eligible for Medicare.
However, this is a normal part of the process.
The agency or company should be able to provide you with the information you need.
Medicaid is a government-run program for low-income Americans.
Although Medicaid is a government-run program, it’s typically administered by private insurance companies.
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