This Brief was prepared by Erika Ziller and Trish Riley of the Muskie School of Public Service to inform an April 8, 2013 colloquium convened to explore options and implications of the Affordable Care Act (ACA) for Maine.
Highlights: In addition to increased Medicaid funding, in January 2014, the ACA will provide federally subsidized health care coverage for individuals with incomes up to 400% for Medicaid in a state, coverage will be subsidized by federally funded tax credits through health insurance exchanges, now known as the “Marketplace.” Those under 100% FPL are not eligible for Marketplace subsidies but could be eligible for Medicaid, depending upon state decisions.
Even if Maine does not choose to cover all those newly eligible under the ACA, beginning in 2014, MaineCare must extend eligibility for children aging out of foster care until they are 26, regardless of income. An estimated 46,000 uninsured individuals, nearly all of whom will be adults without children, would be newly eligible for Medicaid should Maine decide to participate in the ACA optional Medicaid coverage.
If Maine chooses not to participate in the ACA optional Medicaid program, the 14,000 uninsured childless adults with incomes between 100% and 138% FPL referenced above would be eligible to participate in subsidized coverage through the federal Marketplace, although there is disagreement over the affordability of these plans for this group. The 32,000 uninsured childless adults with incomes below 100% FPL would be ineligible for any subsidy through the Marketplace.
Continued coverage for currently eligible populations in Maine is uncertain. Maine must comply with a significant number of ACA provisions related MaineCare. These new requirements must be in place in all states, whether or not states extend eligibility in the Medicaid program or operate a health insurance Marketplace.