ACA ACA Medicaid Expansion & Public Programs 1 — Questions and Answers
Question 1: Under the ACA, Medicaid expansion extended eligibility to adults with incomes up to what percentage of the federal poverty level (FPL)?
- 100% FPL
- 133% FPL
- 138% FPL (Correct answer)
- 150% FPL
Correct answer: 138% FPL
The ACA's Medicaid expansion covers adults with household incomes up to 138% of the FPL (133% plus a 5% income disregard).
Question 2: What was the Supreme Court ruling in NFIB v. Sebelius (2012) regarding ACA Medicaid expansion?
- States are required to expand Medicaid or lose all federal Medicaid funding
- States may choose whether to expand Medicaid without losing existing federal Medicaid funding (Correct answer)
- All states must expand Medicaid within 2 years
- Medicaid expansion was ruled unconstitutional
Correct answer: States may choose whether to expand Medicaid without losing existing federal Medicaid funding
In NFIB v. Sebelius, the Supreme Court ruled that states could opt out of Medicaid expansion without losing their existing federal Medicaid funding, making expansion voluntary.
Question 3: Under the ACA, what is the federal government's matching rate (FMAP) for newly eligible Medicaid expansion enrollees?
- 50% federal match
- 75% federal match
- 90% federal match
- 100% federal match through 2020, then 90% (Correct answer)
Correct answer: 100% federal match through 2020, then 90%
The federal government paid 100% of Medicaid expansion costs through 2016, phasing down to a permanent 90% federal match starting in 2020.
Question 4: Which population group was newly eligible for Medicaid under ACA expansion that was not previously covered in most states?
- Children under age 19
- Low-income adults without dependent children (Correct answer)
- Pregnant women above 138% FPL
- Seniors eligible for Medicare
Correct answer: Low-income adults without dependent children
Before ACA expansion, most states did not cover childless adults regardless of income; the ACA created a new eligibility category for low-income adults without dependent children.
Question 5: What is the 'coverage gap' that exists in non-expansion states under the ACA?
- People earning above 400% FPL who can't afford Marketplace plans
- Adults who earn too much for traditional Medicaid but too little for Marketplace subsidies (Correct answer)
- Children between ages 19 and 26 dropped from parental coverage
- Part-time workers excluded from employer plans
Correct answer: Adults who earn too much for traditional Medicaid but too little for Marketplace subsidies
In non-expansion states, adults above the state's traditional Medicaid income limit but below 100% FPL fall into a coverage gap: ineligible for Medicaid and ineligible for Marketplace premium tax credits.
Question 6: Under the ACA, which federal agency oversees Medicaid program administration and expansion implementation?
- The Department of Labor (DOL)
- The Centers for Medicare & Medicaid Services (CMS) (Correct answer)
- The Department of Health and Human Services Office of Civil Rights
- The Internal Revenue Service (IRS)
Correct answer: The Centers for Medicare & Medicaid Services (CMS)
The Centers for Medicare & Medicaid Services (CMS) within HHS administers Medicaid at the federal level and oversees state implementation of ACA expansion.
ACA ACA Medicaid Expansion & Public Programs 1
Under the ACA, Medicaid expansion extended eligibility to adults with incomes up to what percentage of the federal poverty level (FPL)?