Medicaid programs vary substantially from state to state. It has become increasingly important for sleep providers to familiarize themselves with Medicaid policy as more people become eligible for Medicaid due to program expansions. Visit the Centers for Medicare & Medicaid Services website to access state-specific Medicaid information.
When the Medicaid program was first established, the objective was to provide coverage to low-income children, pregnant women, elderly and disabled individuals. When the Affordable Care Act (ACA) was signed into law in 2010, it expanded the Medicaid program to cover all individuals at or below 138 percent of the federal poverty level.
However, when the Supreme Court upheld the Affordable Care Act in 2012, it provided states the option to either proceed with Medicaid expansion or to opt out of this specific feature of the ACA. By opting out, states did not lose their existing federal Medicaid funding; rather they were simply excluded from the federal funding associated with the ACA’s Medicaid expansion.
As of September 2019, 37 states including the District of Columbia have chosen to implement Medicaid expansion. Some states are choosing to use federal money to help low income individuals purchase private coverage through their state exchanges. Other states are requiring cost-sharing provisions for some of the newly covered Medicaid beneficiaries.
For some states, Medicaid expansion increases coverage for a substantial number of state residents. For example, California now covers an additional 3.8 million residents, and as many as 750,000 new residents will be covered in Pennsylvania. The Kaiser Family Foundation monitors state implementation of Medicaid expansion and maintains up-to-date information on their website.
For assistance with Medicaid-related policy issues, contact the American Academy of Sleep Medicine at firstname.lastname@example.org.