Full Answer
What is the status of Maine’s Medicaid expansion?
CMS officially approved Maine’s Medicaid expansion plan in April 2019 (this was essentially a formality, as expanded Medicaid without modifications is allowed in every state under the terms of the ACA).
What are the income guidelines for MaineCare expansion?
MaineCare Expansion Income Guidelines Household Size Monthly Income MaineCare under 138% Annual Income MaineCare under 138% 3 $2,526 $30,304.80 4 $3,048 $36,570.00 additional household members add... $523 $6,265.20 last updated on 01/19/2021 2 more rows ...
What's new with MaineCare (Medicaid)?
MaineCare (Medicaid) has expanded! Here’s what you need to know. If your income is under 138% of the federal poverty level, you’re eligible for MaineCare. additional household members add... Assets do not count. You can own a home and have savings and still get MaineCare. You can apply for MaineCare starting July 2, 2018.
Is Medicaid expansion worth the cost?
While hundreds of studies have detailed the costs and benefits of Medicaid expansion in terms of access to care, fiscal impacts, health outcomes, and other factors, consensus remains elusive. 1 Many skeptics still question whether expansion is worthwhile from a budget perspective.
How much does Medicare cost the taxpayers?
Medicare accounts for a significant portion of federal spending. In fiscal year 2020, the Medicare program cost $776 billion — about 12 percent of total federal government spending. Medicare was the second largest program in the federal budget last year, after Social Security.
Does Maine have Medicaid expansion?
MaineCare Expansion was passed by voters in November 2017. Almost 80,000 more Mainers are eligible for free MaineCare insurance. Who is eligible for Expansion? People age 21 to 64, who are not eligible for Medicare, with income less than the limit shown for their family size in this chart are eligible.
Does Medicaid Expansion Cost States?
Expansion has produced net savings for many states. That's because the federal government pays the vast majority of the cost of expansion coverage, while expansion generates offsetting savings and, in many states, raises more revenue from the taxes that some states impose on health plans and providers.
What is the income limit for Medicaid in Maine?
To be eligible, you must have an annual household income (before taxes) that is below the following amounts: 1....Maine MaineCare?Household Size*Maximum Income Level (Per Year)1$18,0752$24,3533$30,6304$36,9084 more rows
What is the income limit for MaineCare?
You may be eligible for MaineCare if your monthly income (before you pay taxes) is up to:Your household sizeChildrenYoung Adults (19-20)1$2,413$1,8242$3,251$2,4573$4,088$3,0904$4,926$3,7241 more row
What is the asset limit for MaineCare?
For children (18 and under) and pregnant women,MaineCare will not count assets. For parents of children (18 and under), and for 19 and 20 year olds, there is a $2,000 asset limit. For other adultcouples with no minor children at home, there is a $3,000 asset limit.
How much does the Affordable Care Act cost taxpayers?
Also prior to this year, ACA subsidies cost taxpayers about $50 billion a year. And yet they led to only about 2 million people gaining exchange-plan coverage. That's a small number in a nation of 330 million.
What are the pros and cons of Medicaid expansion?
List of Medicaid Expansion ProsNot every low-income individual actually qualifies for Medicaid. ... Expansion would support local economies. ... It offers people a level of financial protection. ... Medicaid expansion drops the uninsured rate. ... The cost of expansion is minimal for the states.More items...•
Why did Florida not expand Medicaid?
Florida has set below-average limits for the mandatory coverage groups, and since the state has not accepted federal funding to expand Medicaid, the eligibility rules have not changed with the implementation of the ACA.
Does Social Security count as income for MaineCare?
Income: Includes household money from sources such as Social Security, pensions, wages, alimony, self-employment, etc.
How much is MaineCare a month?
There is a monthly fee of $8-$64 depending on income and family size. Children remain eligible for coverage for 12 months. Full MaineCare Benefit 105% of FPL 1: $1,093 2: $1,480 3: $1,867 4: $2,254 Each additional person: $387 Must be residing with and caring for a dependent child under the age of 18.
What is the income limit for MaineCare 2022?
This may include Medicare premiums, eyeglasses, dental services, and doctor visits. In 2022, the medically needy income limit (MNIL), also called a protected income level in ME, is $315 / month for an individual and $341 / month for a couple.
When did Maine end Medicaid?
Second, Maine ended coverage for adults without dependents, effective Jan. 1, 2014. The stricter eligibility limits resulted in about 25,000 people losing Medicaid eligibility.
How many people will be on medicaid in Maine in 2020?
Total Medicaid enrollment in Maine as of June 2020 was 219,992 ; CHIP enrollment was 12,463. Enrollment specific to Medicaid expansion in Maine was nearly 63,000 as of October 1, 2020. That figure is expected to eventually climb to 70,000 to 80,000 people.
What was the wording of the Medicaid expansion ballot initiative?
But the wording of the ballot initiative became a point of contention, with proponents of Medicaid expansion calling it “insurance” and opponents — including LePage — insisting that it be called “welfare” or something similar. Ultimately, the wording of the ballot initiative was changed to “coverage” and the official language ...
How many people have enrolled in expanded medicaid?
Enrollment in expanded Medicaid began immediately after Mills issued her executive order, and within a week, more than 500 people had enrolled, in addition to more than 6,000 people who had applied for coverage in the second half of 2018 (consumer advocacy groups had been encouraging eligible residents to enroll, as they knew there was a possibility of retroactive coverage eventually being granted).
What was the success of the Maine ballot measure?
The success of the ballot measure in Maine inspired similar initiatives in other states where there was strong grassroots support for expansion (despite the fact that Maine faced such an uphill battle with the governor’s resistance to implementing the will of the voters).
When did Lepage take office in Maine?
The state fell behind in Medicaid reimbursements to hospitals, which were due nearly $500 million in state and federal payments. LePage took office in 2011 and led efforts to cut Maine’s Medicaid program.
Which state was the first to expand Medicaid?
Maine first to adopt Medicaid expansion via ballot initiative. In all of the other states that had expanded Medicaid before Maine did, the decision was made either by lawmakers or the governor or both — Maine was the first state where the issue was decided via ballot initiative.
How much does Medicare pay for outpatient therapy?
After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and Durable Medical Equipment (DME) Part C premium. The Part C monthly Premium varies by plan.
What is Medicare Advantage Plan?
A Medicare Advantage Plan (Part C) (like an HMO or PPO) or another Medicare health plan that offers Medicare prescription drug coverage. Creditable prescription drug coverage. In general, you'll have to pay this penalty for as long as you have a Medicare drug plan.
How much is coinsurance for days 91 and beyond?
Days 91 and beyond: $742 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime). Beyond Lifetime reserve days : All costs. Note. You pay for private-duty nursing, a television, or a phone in your room.
How much is coinsurance for 61-90?
Days 61-90: $371 coinsurance per day of each benefit period. Days 91 and beyond: $742 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) Beyond lifetime reserve days: all costs. Part B premium.
What happens if you don't buy Medicare?
If you don't buy it when you're first eligible, your monthly premium may go up 10%. (You'll have to pay the higher premium for twice the number of years you could have had Part A, but didn't sign up.) Part A costs if you have Original Medicare. Note.
Do you pay more for outpatient services in a hospital?
For services that can also be provided in a doctor’s office, you may pay more for outpatient services you get in a hospital than you’ll pay for the same care in a doctor’s office . However, the hospital outpatient Copayment for the service is capped at the inpatient deductible amount.
Does Medicare cover room and board?
Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home). $1,484 Deductible for each Benefit period . Days 1–60: $0 Coinsurance for each benefit period. Days 61–90: $371 coinsurance per day of each benefit period.
How does Medicaid expansion affect the state?
The cost of Medicaid expansion can sometimes be offset by increased revenues for the state, including revenue from taxes/fees assessed on hospitals, medical providers, and insurers, increased tax revenue due to economic growth linked to Medicaid expansion, and premiums that some states require some Medicaid expansion enrollees to pay.
How many states have expanded Medicaid?
36 states and the District of Columbia have expanded Medicaid as of early 2021, and two more — Oklahoma and Missouri — will expand Medicaid in mid-2021. Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006.
Why is Medicaid expansion important?
There are a few reasons for that: Medicaid expansion allows some states to shift certain populations from traditional Medicaid eligibility to the Medicaid expansion category, where the federal government pays a much larger portion of the cost.
How much does Medicaid pay in 2020?
The federal government’s portion gradually dropped to 90 percent by 2020, and it now stays there permanently (for perspective, under traditional Medicaid, states can pay up to 50 percent of the cost ).
When did the federal government pay for the expansion?
The federal government paid the full cost of expansion from 2014 through 2016. The federal government's portion gradually dropped to 90 percent by 2020, and will stay there permanently. Q.
Does Medicaid cover 10 percent of the cost?
For states that expand Medicaid, the federal funding they receive will always dwarf the amount that the state has to spend. And although states have to cover 10 percent of the cost of Medicaid expansion, their net spending can be much less than that — even negative in some cases. There are a few reasons for that:
How does Medicaid expansion affect state spending?
The Impact of Medicaid Expansion on State Spending. States must finance a share of the cost of expansion. As such, expanding Medicaid will increase state spending. However, expanding Medicaid also allows states to reduce spending on traditional Medicaid.
What are the benefits of Medicaid expansion?
Prior studies identify several areas where expanding Medicaid reduces other state spending. 9 The three most common include: 1 Mental health and substance abuse treatment: Many states directly support mental health and substance abuse treatment for low-income people without health insurance. With Medicaid expansion, recipients may obtain these services via Medicaid. 2 Corrections: Medicaid expansion allows states to shift the cost of some inmates’ health care from the state corrections budget to Medicaid. 10 3 Uncompensated care: Many states help offset the cost of providing care to people who cannot pay their medical bills. By reducing the number of people without insurance, Medicaid expansion significantly reduces the amount of uncompensated care. 11 Therefore, some states have chosen to reduce payments to health care providers for uncompensated care.
What are the teal bars on Medicaid?
The teal bars show the two competing effects of expansion on state Medicaid spending. During FY2015 and FY2016, the federal government paid the full cost of expansion and Medicaid spending in expansion states declined by approximately 6 percent relative to nonexpansion states.
How much of Medicaid expansion is offset in Kentucky?
In Kentucky, these categories of savings offset roughly 14 percent of Medicaid expansion’s costs. In Arkansas they offset 30 percent and in Michigan they offset 41 percent. 12.
How does expanding eligibility affect Medicaid?
First, expanding eligibility allows states to cut spending in other parts of their Medicaid programs. Second, it allows states to cut spending outside of Medicaid — particularly on state-funded health services for the uninsured.
What happens when states expand Medicaid?
When states expand Medicaid, they may see reduced spending outside of the program. Many states provide health care services to low-income residents; expansion may allow them to provide some of these services via Medicaid.
How much will expansion cost in 2020?
Given recent spending levels, expansion states will collectively pay more than $7 billion in 2020. For the median expansion state, expansion will cost more than $100 million. 2. These costs represent the “sticker price” of expansion. However, its actual fiscal impact differs from the sticker price for three reasons.