* Kaiser found widespread Medicaid coverage gaps
* Only nine states offer benefits to childless adults
* Obama law to cover most near poverty line next January
By David Morgan
WASHINGTON, Jan 23 U.S. adults who qualify for
Medicaid often must have incomes well below the federal poverty
line, while adults who have no dependent children are allowed to
receive benefits in only nine of the 50 states, according to a
survey released on Wednesday.
The survey by the nonpartisan Kaiser Family Foundation
provides a snapshot of widespread coverage gaps in national
healthcare program for the poor, less than a year before
Medicaid is scheduled to undergo a dramatic expansion under
President Barack Obama's healthcare reform law.
Kaiser, which tracks health issues, found that Medicaid
coverage in 2012 was stable for children and pregnant women, who
are among the program's targeted beneficiary groups.
But eligibility for parents was limited on average to those
earning no more than 61 percent of the federal poverty line,
which equals about $19,000 a year for a family of three.
Thirty-three states required parents to earn less than the
poverty rate, with 16 restricting eligibility to less than 50
Nine states extended full Medicaid coverage to adults
without dependent children while three states, Hawaii, Illinois
and Minnesota, reduced eligibility for adults where it was not
required by federal rules.
Medicaid, which is run by states but has federal funding and
oversight, represents a major budget expenditure for state
governments. Many have sought to curtail benefits and
eligibility in recent years because of fiscal constraints
imposed by the recession and a slow economic recovery.
Benefits and eligibility can vary widely from state to
state, with many limiting Medicaid coverage to defined groups,
including children and their parents, pregnant women, the very
old and people suffering from certain health conditions.
Obama's reform law, known as the Patient Protection and
Affordable Care Act, offers states Medicaid funding to provide
health coverage for most Americans earning up to 133 percent of
the poverty rate from Jan. 1, 2014. The cut-off equals about
$24,000 for a family of three in 2012 dollars.
But the expansion has encountered political resistance,
mainly from Republicans. More than half of state governors have
yet to support the expansion. Just over a dozen have rejected
the plan as a costly and unnecessary government program and more
are expected to decide whether to back the expansion in coming
weeks, as they roll out budget proposals for the new year.
Even as state Medicaid programs fail to reach large numbers
of the country's poor, Kaiser reported that nearly all states
are pressing forward with federally funded technological
improvements to streamline their Medicaid enrollment systems and
provide online access under the healthcare law.
As of Jan. 1, 37 states had an online application for
Medicaid or the federal program for children, up four from a
year earlier. Twenty-eight states now allow families to renew
their benefits online, an increase of eight since the start of
"On balance, states made more positive improvements than
adverse changes (in 2012), often capitalizing on technology to
gain administrative efficiencies and reduce paperwork," the
Kaiser survey said.