As of a few hours ago, North Carolina has started to accept enrollment and begin coverage in Medicaid for adults ages 19-64 with incomes under 138% Federal Poverty Level (FPL.). This expansion is authorized by the ACA but made voluntary by the Supreme Court and enriched by the passage of the American Rescue Plan Act (ARPA). ARPA gave states that had yet to expand Medicaid a fairly large federal bonus to expand Medicaid.
The state is moving several hundred thousand individuals who had limited benefit Medicaid (mainly family planning services), to full benefits today. ID cards are on the way.
There is going to be a somewhat odd experience for people using Healthcare.gov to buy insurance. Healthcare.gov (and any state based marketplace) conducts a plausible eligibility check based on income whenever someone actively engages with the platform. If someone is plausibly eligible, Healthcare.gov holds the ACA enrollment and sends the person to Medicaid. Remember, the ACA subsidies are designed to be the subsidies of last resort and are not available if an individual has coverage available elsewhere.
However the presumptive eligibility check is against the rules in place as of the day that the check is made. So someone whose income was between 100-138% FPL and who had a check done on them in November would qualify for a Silver CSR plan that starts January 1, 2024. However that same person going on Healthcare.gov today will be sent to Medicaid. The big news is if you went on Healthcare.gov in November with an income under 100% FPL, go back on today as you’re now eligible for North Carolina Medicaid.
On The Road – lashonharangue – Green River 2023 – Part 2
RevRick
This is flat out wonderful news. Considering how retrograde the NC legislature is, it seems like something of a miracle. And given that Trump has voiced his determination to put an ax to the ACA, it may be a sign of hope that it will survive nevertheless.
rikyrah
Yessssss 🙌🏽🙌🏽
Ohio Mom
I wonder how much the complexity — first I was eligible for that , now I’m being switched to this — leads to people not taking advantage of this wonderful development.
MomSense
Medicaid is life changing. Let’s hope it won’t be too complicated to enroll.
Freemark
What do you think is better, Medicaid or high CSR Silver? Had some time off work and will probably qualify for Medicaid but could move $2000 from an old 401k to a Roth and that would put me just enough to get a high CSR plan. No premium, to me, $1 copay and a $300 deductible.
Ohio Mom
@MomSense: I always say that Ohio Son’s Medicaid (which he was eligible for as a disabled person) was the best coverage any of us in Ohio Family have ever had. There was no cost and it was completely hassle-free.
Since Ohio Dad retired, Ohio Son is now on Medicare, with Medicaid as a secondary insurer. This arrangement is not completely free and has some confusing aspects. Still, we’ll take it.
I keep saying, forget Medicare for all, make it Medicaid for all.
David Anderson
@Freemark: longer post later