As passed by Congress, the Affordable Care Act (ACA) required states to begin in 2014 to offer Medicaid coverage to everyone below 138 percent of the poverty level (except for non-citizens who are undocumented or have not lawfully resided in the U.S. for at least five years). However, the U.S. Supreme Court’s July 2012 decision struck down the requirement, and that ruling makes those Medicaid provisions optional for the states.
The ACA provides funding to cover nearly all of the costs of newly-eligible adults with incomes below 138 percent of the federal poverty level (FPL). Over the first three years (2014 through 2016), the federal government will pay all of the costs of extending Medicaid to those adults, followed by a gradual phase-down over the next few years to 90 percent of the cost in 2020 and thereafter.
Wisconsin’s BadgerCare program already covers parents to 200 percent of FPL, but only a small portion of low-income adults who aren’t custodial parents. The BadgerCare Core program, initiated in 2009, now covers only about 21,000 non-caretaker adults (which is down from a peak of about 65,000 early in 2010), and there is a waiting list of about 146,000. The Medicaid option in the ACA gives Wisconsin the capacity to fill the large gap in BadgerCare for those non-caretaker adults with incomes below 138 percent of FPL.
