Wisconsin is one of the most structurally unusual states in the country when it comes to Medicaid expansion — and understanding the difference matters if you’re trying to figure out whether you qualify. Wisconsin has not expanded Medicaid under the standard ACA framework that covers adults up to 138% FPL. Instead, Wisconsin covers childless adults …
West Virginia expanded Medicaid in January 2014 — and that decision has had consequences well beyond what most state expansions produce. West Virginia has the nation’s highest drug overdose death rate, and Medicaid expansion became a primary mechanism for connecting residents to substance use treatment and mental health services. By early 2017, more than 22,000 …
Washington’s Medicaid program is called Apple Health — and it’s one of the most expansive in the country by both coverage breadth and income thresholds. Two features set Washington apart from virtually every other state in this series: Immigrant coverage — As of July 2024, Washington extended Apple Health to undocumented adults with incomes up …
Virginia’s Medicaid program goes by two names depending on the context. The state brands its Medicaid managed care system as Cardinal Care — the umbrella program through which most Virginia Medicaid recipients receive coverage. The federal enrollment program is called Cover Virginia — the state’s Medicaid outreach and enrollment brand administered by DMAS. What sets …
Wyoming Medicaid, administered by the Wyoming Department of Health (WDH), is a health Wyoming Medicaid is officially branded as EqualityCare — named in keeping with Wyoming’s identity as the “Equality State” — and is administered by the Wyoming Department of Health (WDH). It provides health coverage to low-income Wyoming residents including children, pregnant women, parents, seniors, and people …
Vermont’s Medicaid program is called Green Mountain Care — and Vermont is among the most health-insured states in the country, with one of the lowest uninsured rates in the United States even before the ACA. That’s not an accident. Vermont had already built near-universal coverage for low-income residents through earlier state programs like VHAP and …
Utah’s Medicaid expansion has one of the most unusual political histories of any state in the country. Utah voters approved full ACA expansion to 138% FPL via a 2018 ballot initiative, with 53%+ support. Then the state legislature passed a scaled-back version — capping coverage at 100% FPL through a Section 1115 waiver. Then the …
Texas Medicaid serves over 5 million Texans — more than any non-expansion state in the country — through one of the most elaborate managed care architectures in the United States. Almost every Texas Medicaid recipient gets coverage through a named managed care program — STAR, STAR+PLUS, or STAR Kids — each targeting a different population …
Tennessee’s Medicaid program is called TennCare — and it’s one of the most structured managed care Medicaid systems in the country, operating entirely through three contracted managed care organizations: UnitedHealthcare, BlueCare (BlueCross BlueShield of Tennessee), and Wellpoint. Every TennCare enrollee receives care through one of these MCOs, which coordinate medical, behavioral health, and pharmacy benefits …
Oregon Medicaid — the Oregon Health Plan (OHP) — covers over 1.4 million Oregonians and offers something no other state program does quite the same way: the OHP Bridge Plan, a Basic Health Program that extends coverage to adults earning between 138% and 200% of the Federal Poverty Level — a gap most states leave …