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What Can Medicaid do for YOU?

March 6, 2013SarahBlog

Do you qualify for Medicaid? New rules starting in 2014

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The Illinois Senate approved Medicaid Expansion last week. As part of the Affordable Care Act, States have the option to expand Medicaid coverage for individuals that are currently ineligible. Under current Medicaid requirements, adults who do not meet a specific categorical requirement (such as being older than age 65, have certain disabilities or is a parent of a child under 18) have never been eligible for any public health care coverage under Medicaid, even if they are very low income.  For Illinois, this means approximately 600,000 people would be eligible starting in 2014 because they are below 138% of the Federal Poverty Limit. You or someone you know might qualify. Below are key components and expected benefits of Medicaid Expansion in Illinois.


Key components of Senate Bill 26:

  • All adults with incomes at or below 138 percent of the Federal Poverty Limit ($15,415 for an individual) will be able to enroll in Medicaid starting January 1, 2014. Currently, adults are eligible for Medicaid only if they have disabilities or care for dependent children.
  • The federal government will reimburse Illinois for 100 percent of the costs of covering these newly eligible enrollees through 2017.
  • The reimbursement rate will decrease gradually after 2017 but stay at 90 percent after 2020.
  • If the federal government fails to reimburse the state at 90 percent or above, the newly eligible clients will become ineligible; Illinois will not be stuck with the bill.


Expected benefits include:

  • Access to routine, coordinated care for 342,000 low-income adults
  • Fewer unnecessary and uncompensated emergency room visits
  • An influx of $1.1 billion in federal dollars in the first year and more than $12 billion in federal funds in the first eight years of the expansion
  • Job creation in the health care sector
  • $105 million in annual savings to the state as federal funds replace state expenditures on mental health, HIV/AIDS drugs and other areas of spending
  • A reduction in the burden on hospitals and local government currently caring for the uninsured
  • Better preventive care and mental health care for a vulnerable segment of the population[1]

[1] State Senator Van Pelt on the Illinois Senate vote to expand Medicaid, last modified February 23, 2013, http://senatorvanpelt.com/index.php/news/81-state-senator-van-pelt-on-the-illinois-senate-vote-to-expand-medicaid.

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