The Affordable Care Act (ACA) gives individual states the option to expand Medicaid to new adults earning up to 138% of Federal Poverty Level (FPL). Without expansion, there is a gap in coverage for adults who do not currently qualify for Medicaid and are ineligible to receive benefits and subsidies through the federally facilitated marketplace. After years of deliberation and research, state leaders have developed a plan for a Utah-specific approach to reduce the number of the uninsured adults in the state.
During the 2016 Legislative Session, House Bill 437 passed and directed the Utah Department of Health’s Medicaid agency to implement a health coverage improvement plan. Based on funding and approval from the Centers for Medicare and Medicaid Services (CMS) the program is designed to provide Medicaid coverage for the following adults:
- Parents with dependent children earning up to 60% of the FPL
- Adults without dependent children earning up to 5% of the FPL who are:
- Chronically homeless
- Involved in the justice system through probation, parole, or court ordered treatment needing substance abuse or mental health treatment
- Needing substance abuse treatment or mental health treatment