Medicaid: An Overview

Health insurance is an important part of keeping healthy. Today we’re going to be looking at an overview of .

Medicaid, not Medicare

Medicaid provides health insurance to over 97 million low-income Americans. Month-to-month, Medicaid has served 32 million children, 28 million adults (who are mostly in low-income families), 6 million seniors, and 9 million people with disabilities. Medicaid can sometimes be confused with Medicare- the federally administered healthcare option for people over 65. However, there is an overlap between the two: 10 million “dual eligibles,” or low-income seniors or people with disabilities, are enrolled in both health insurances.

What is Medicaid?

This health insurance is what is called a counter-cyclical program, which means the enrollment changes to meet the ever-present needs during an economic downturn, which is when people lose their jobs and the health insurance that may come with it. Back in the Great Recession of 07, over 10 million people, with roughly half being children, enrolled in Medicaid.

As economic crises happen throughout COVID-19 and public health is at risk, Medicaid enrollment will only rise. This helps millions of people without a job stay insured.

Who is eligible for Medicaid?

Medicaid is an “entitlement program,” which means that once you meet the eligibility rules, you have every right to enroll for coverage. States have guaranteed financial assistance for part of the cost of the programs.

You must meet these requirements to be eligible

  • Children through the age of 18 in families with income below 138% of the federal poverty line ($29,974 for a family of 3 in 2020)
  • Pregnant people with an income below 138% of the poverty line
  • Certain parents or caretakers with very low income
  • Most seniors and people with disabilities who receive cash assistance through the Supplemental Security Income (SSI) program

Depending on where you live, your state may have funds to cover ‘optional’ populations.

  • People in the list above who exceed the limits for “mandatory” coverage
  • Seniors and people with disabilities who don’t receive SSI, whose income is below the poverty line
  • “Medically needy” people whose income exceeds the necessary limit for Medicaid, but have high medical expenses (such as nursing home care) that reduce their monthly wages to below the poverty line

Thanks to the Affordable Care Act (ACA), people with higher incomes who need long-term services and supports, as well as non-disabled adults with income below 138% of the poverty line, including those without children are also eligible for Medicaid.

Not all people with lower incomes are automatically eligible for Medicaid. 15 states have not implemented the ACA Medicaid expansion as of April 2020, so adults over 21 are generally ineligible for Medicaid, no matter how low their incomes are unless they are pregnant, caring for children, elderly, or disabled. If you’re in a non-expansion state, even a parent may be ineligible if their income exceeds just over 42% of the poverty threshold ($9,122 for a family of three).

People who are not U.S. citizens are also ineligible for Medicaid, despite the fact that they have a lawful immigration status. This means that people living in the United States for humanitarian reasons, school, work, or travel are ineligible for Medicaid as a health insurance option. Green card holders are also unable to enroll in Medicaid for the first five years of their citizenship, whether or not they meet the eligibility criteria. It’s the state’s option to extend the eligibility if the green card holder is pregnant or has children.

Originally published at




Based in Knoxville, TN, Hazen Mirts is the President & CEO of Enrollment First, Inc. To learn more, please visit

Love podcasts or audiobooks? Learn on the go with our new app.

Recommended from Medium

The Bad News in a Good Way for Dems


A tale of two countries, two leaders, and one virus.

WTF are Republicans doing?

Suppose 'tis still the case

The Long Con (Part III)

Redefining Trust: Weaknesses in Modern Voting Systems

The Past & Future of Your Right to Remain Anonymous

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store
Hazen Mirts

Hazen Mirts

Based in Knoxville, TN, Hazen Mirts is the President & CEO of Enrollment First, Inc. To learn more, please visit

More from Medium

Introducing a New Way to Take Control of Corporate Credit Card Spend

Introducing a New Way to Take Control of Corporate Credit Card Spend

Time for Canada to be a leader again, not a laggard, in the fight for global health

How to choose a primary beneficiary?

This Stanford Student Is Closing The Digital Divide By Connecting Nonprofits And Underrepresented…