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Policy Clearinghouse

Expanded Income Eligibility for Health Insurance

Expanded income eligibility for health insurance positively impacts these policy goals:

SUMMARY

Expanded income eligibility for health insurance is an effective state policy to impact:

Expanding Medicaid income eligibility at or below 138 percent of the federal poverty level (FPL) is an effective strategy to increase health insurance coverage, improve access to perinatal care, and reduce family financial burdens. Although overall findings are mixed, rigorous studies of expanding Medicaid income eligibility suggest beneficial findings in maternal mortality and child neglect rates.

Medicaid is a joint federal-state program that provides health insurance coverage to people with low incomes. Medicaid is an open-ended entitlement, which means that individuals who meet eligibility criteria, usually determined by income level as a percent of the FPL, qualify to receive health insurance coverage.

States administer Medicaid and have the flexibility to determine income eligibility thresholds for the types of covered services and populations of individuals that qualify for Medicaid coverage (including childless adults, parents, and pregnant individuals). Because of this flexibility, income eligibility requirements for Medicaid vary across states. Expanding Medicaid eligibility at or below 138 percent of the FPL increases the number of adults who are entitled to Medicaid coverage, decreases the number of uninsured people, and increases health and financial wellbeing. This policy lever has been well studied, but other policy levers that are not within the scope of this review such as state-run health insurance plans and extension of postpartum Medicaid coverage can also increase the number of insured people.


Download the Complete Evidence Review

Expanded Income Eligibility for Health Insurance Evidence Review (PDF)

Recommended Citation:
Prenatal-to-3 Policy Impact Center. (2023). Prenatal-to-3 policy clearinghouse evidence review: Expanded Income Eligibility for Health Insurance (ER 01D.0923). Peabody College of Education and Human Development, Vanderbilt University. https://pn3policy.org/policy-clearinghouse/expanded-income-eligibility-for-health-insurance

Updated September 2023

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