Medicaid Expansion

April 1, 2010

Medicaid is currently a safety net system that does not serve nearly half of those living under the poverty line. Complex rules limit eligibility to people who fall into certain categories, such as pregnant women, children, the disabled, some parents, and women with breast and cervical cancer. Consequently, many low-income adults with cancer are left with no coverage options.

The Affordable Care Act gives all people under 133% of the federal poverty level (about $14,050 for a single adult) access to Medicaid. Those who do not fit into the previously listed groups will be considered the “newly eligible.”

Fast Facts

  • As of January 2010, low-income adults without dependent children could not qualify for Medicaid in 43 states.
  • Currently, 45% of those living under the poverty line are uninsured.
  • 15 million additional people will be covered by Medicaid after implementation of the Affordable Care Act.

 Increasing access to care for our nation’s most vulnerable populations is a critical step in the fight against cancer.

Highlights of Medicaid Expansion in the Affordable Care Act

  • Expands eligibility to all people under 133% of the federal poverty level (Beginning January 1, 2014)
  • Beneficiaries who are not already eligible for Medicaid through existing classifications are considered the “newly eligible”
  • States may not restrict their eligibility or enrollment practices for Medicaid until the health insurance exchanges are fully operational
  • People may enroll in Medicaid through the exchange or through other traditional Medicaid venues
  • By 2020, all states will receive a 90% federal funding match for the newly eligible population. Starting in 2014, states that already cover this population will receive a 50% match, increasing to 90% in 2019. States that do not already cover this population will receive a 100% match, decreasing to 90% in 2020

Implications for the American Cancer Society and American Cancer Society Cancer Action Network (ACS CAN)

  • ACS CAN will continue to advocate for increased access to the full spectrum of care from prevention through treatment and quality end of life care, especially for our nation’s most vulnerable and medically underserved populations.
  • In 2014, all Americans with cancer under 133% of the Federal Poverty Level, regardless of cancer site, will be eligible for Medicaid coverage.
  • Increased access to care, especially for a population at higher risk of cancer, will help to detect diseases such as cancer early, when there are more options for treatment and better chances of survival.