This Medicaid primer provides an overview of the nation’s largest health coverage program, which covers more than 62 million low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare. Medicaid also is the dominant source of the country’s long-term care financing. The program will expand significantly under the Affordable Care Act in 2014.
More than a decade after its enactment, the future of the Affordable Care Act (ACA) remains uncertain as the U.S. Supreme Court takes up another challenge to the law’s constitutionality in California v. Texas (known as Texas v. U.S. in the lower courts). Oral argument is scheduled for Tuesday, November 10, 2020.
The ACA remains in effect while the litigation is pending. However, if all or most of the law ultimately is struck down, it will have complex and far-reaching consequences for the nation’s health care system, affecting nearly everyone in some way.
For information about ACA Marketplace Open Enrollment, including fact sheets and 300+ FAQs, visit our collection of resources on Understanding Health Insurance.
Featured Affordable Care Act Resources
This issue brief answers key questions about California v. Texas (known as Texas v. US in the lower courts), the case challenging the Affordable Care Act to be heard by the Supreme Court.
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- Is COVID-19 a Pre-Existing Condition? What Could Happen if the ACA is Overturned
- Mental Illnesses May Soon Be the Most Common Pre-Existing Conditions
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- Eliminating the ACA: What Could It Mean for Medicaid Expansion?
- Loss of the Affordable Care Act Would Widen Racial Disparities in Health Coverage
- Loss of the ACA Could Greatly Erode Health Coverage and Benefits for Women
- The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
- FAQs: Health Insurance Marketplace and the ACA
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The Supreme Court will review the constitutionality of the Affordable Care Act (ACA) this November in California v. Texas. This fact sheet summarizes the major provisions of the ACA, illustrating the breadth of its changes to the health care system. If all of most of the ACA is struck down, many of these provisions could be eliminated.
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A new Kaiser analysis sheds light on how the country might react to the Affordable Care Act (ACA) when it is implemented. It looks at how the benefits of the ACA’s coverage expansions will vary around the country by census areas (technically, Public Use Microdata Areas, or PUMAs). PUMAs are…
How is the Affordable Care Act Leading to Changes in Medicaid Today? State Responses to Five New Options
This policy brief examines how states in every region have responded to five key opportunities available under the health reform law to help them prepare for the significant expansion of Medicaid in 2014. The options covered in the brief include incentives for states to get an early start on the…
What is remarkable about 2012 (and the current era in health policy) is how many big health policy issues and marketplace changes will be in play at the same time: HEALTH REFORM: There is the implementation of a historic but fragile health reform law, with a Supreme Court decision pending…
A Historical Review of How States Have Responded to the Availability of Federal Funds for Health Coverage
This historical review finds that the availability of federal funds has served as an effective incentive for states to provide health coverage to meet the health and long-term care needs of their low-income residents despite state budget pressures. The brief examines the history of earlier experiences and provides important context for how states may respond as they weigh the costs and benefits of expanding their Medicaid programs in 2014 as called for under the Affordable Care Act.
This brief examines the latest Congressional Budget Office (CBO) projections for federal Medicaid and CHIP spending over the 2014-2024 period. CBO’s budget projections, also known as “baseline” projections, reflect CBO’s best judgment about how the economy and other factors will affect federal revenues and spending under existing laws. The brief also examines CBO estimates of the coverage effects of the Affordable Care Act (ACA) on Medicaid and CHIP enrollment and spending. Understanding the CBO baseline estimates is important because they are the basis to evaluate the federal cost and coverage implications of proposed federal policy changes.
Medicaid Eligibility, Enrollment Simplification, and Coordination under the Affordable Care Act: A Summary of CMS’s March 23, 2012 Final Rule
This brief provides a summary of the Centers for Medicare and Medicaid Services’ (CMS) March 23, 2012 final rule to implement the ACA provisions relating to Medicaid eligibility, enrollment simplification and coordination. The rule, which is effective Jan. 1, 2014, lays out procedures for states to implement the Medicaid expansion…
This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and businesses.
Note: Congress eliminated the federal tax penalty for not having health insurance, effective January 1, 2019. Along with changes to the health insurance system that guarantee access to coverage to everyone regardless of pre-existing health conditions, the Affordable Care Act includes a requirement that many people be insured or pay…