{"id":355789,"date":"2016-04-04T10:46:14","date_gmt":"2016-04-04T15:46:14","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/healthcare\/medicare-medicaid\/medicaid.html"},"modified":"2024-08-19T17:09:46","modified_gmt":"2024-08-19T22:09:46","slug":"medicaid","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/healthcare\/medicare-medicaid\/medicaid.html","title":{"rendered":"Medicaid Law"},"content":{"rendered":"\n
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Medicaid Law<\/h1>\n
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\n By Melissa McCall, J.D.<\/a> | Legally reviewed by Aviana Cooper, Esq.<\/a>\n | Last reviewed\n
\n \n <\/i>\n Legally Reviewed\n <\/summary>\n\n
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This article has been written and reviewed for legal accuracy, clarity, and style by FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with our editorial standards<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n\n

\n \n <\/i>\n Fact-Checked\n <\/summary>\n\n
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The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n<\/section>\n

Medicaid is a federally mandated, state-administered health care program for low-income U.S. residents. Medicaid is a public health insurance for low-income Americans and lawful residents. Medicaid helps ensure low-income adults and children can access long-term care and healthcare services, which leads to better health outcomes for more people. Individual states and the federal government jointly administer Medicaid through cost-sharing.<\/p>\r\n

The following article highlights the basics of Medicaid<\/a>, including eligibility, coverage, and how to apply for benefits.<\/p>\r\n

Medicaid Basics<\/h2>\r\n

The U.S. Department of Health and Human Services (HHS) jointly administers this medical assistance program with individual states and through the Centers for Medicare and Medicaid Services (CMS). <\/p>\r\n

As of December 2022, the total number of Medicaid enrollees exceeds 90 million<\/a>. The states receive federal funding to administer Medicaid, and they can tailor state Medicaid programs to achieve their long-term healthcare goals. Since states administer Medicaid, each state can set its eligibility requirements.<\/p>\r\n

States must follow CMS regulations in tailoring their programs. States can apply for CMS waivers to try out new programs.<\/p>\r\n

Medicaid Expansion<\/h3>\r\n

President Barack Obama signed the Patient Protection and Affordable Care Act<\/a> (ACA) into law in 2010. The intent of the ACA includes expanding health care coverage for low-income adults. The ACA does this through subsidizing health insurance premiums. Another way is through the Medicaid Expansion<\/a>.<\/p>\r\n

Before the ACA, some low-income adults could not qualify for Medicaid because their incomes were too high. They earned too much money to qualify for medical assistance but not enough to afford insurance premiums. In states with expanded Medicaid, low-income adults can qualify<\/a> if their incomes are 133% of the federal poverty level<\/a>.<\/p>\r\n

Medicaid Eligibility<\/h2>\r\n

The primary factor determining Medicaid<\/a> eligibility is income level. The second eligibility factor is citizenship. Only U.S. citizens or lawful permanent residents can enroll in Medicaid. Medicaid waives this requirement for people with emergency medical conditions, including pregnant women in labor. Some states also offer non-emergency prenatal coverage for pregnant women regardless of immigration status.<\/p>\r\n

Children of families whose income is above the threshold for Medicaid coverage may be eligible for health care benefits through the Children’s Health Insurance Program<\/a> (CHIP).<\/p>\r\n

Financial Eligibility for Medicaid<\/h3>\r\n

For Medicaid eligibility income purposes, states use a household’s modified adjusted gross income (MAGI). MAGI is the adjusted gross income<\/a> plus any of the following:<\/p>\r\n