Covering Low-Income Uninsured Pennsylvanians: The Path to and from Healthy Pennsylvania Medicaid Expansion and the Affordable Care Act

Medicaid Expansion and the Affordable Care Act


On January 1, 2014, several key provisions of the Affordable Care Act (ACA) took effect. People with incomes above the poverty line could buy health insurance through the ACA’s Federally Facilitated Marketplace. People with incomes between 100 percent and 400 percent of the federal poverty income guidelines could receive tax credits and other financial help to make the insurance affordable. 477,000 Pennsylvanians became newly insured through the end of the first federal open enrollment period on March 31, 2014.


Also on January 1, 2014, funding for Medicaid expansion became available to cover people between the ages of 19 and 64 with incomes below 138 percent of the federal poverty income guidelines (slightly more than $16,000 per year for single people) who do not qualify for traditional Medicaid benefits because they are not pregnant, do not have disabilities, or are not very low-income parents. Under the ACA, Medicaid expansion is the only health insurance option for most people below the poverty line who do not meet these categorical requirements. The Pennsylvania Department of Public Welfare (DPW) estimates that more than 600,000 low-income Pennsylvanians make up the Medicaid expansion population.

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