If you’re poor, uninsured and have a bad car wreck or fall seriously ill, there’s a chance in most states to enroll for Medicaid after the fact. If you qualify for Medicaid, the program will pay your medical bills going back three months.
This “retroactive eligibility” provides financial protection as patients await approval of their Medicaid applications. It protects hospitals, too, from having to absorb the costs of caring for these patients.
But a growing number of states are rescinding this benefit. On Nov. 1, Iowa joined three states that have eliminated retroactive coverage for some groups of Medicaid patients since the Affordable Care Act passed.
Each state had to secure approval by the federal government to make the change.
Retroactive eligibility has been a feature of Medicaid for decades, reflecting the program’s emphasis on providing a safety net for poor, disabled and other vulnerable people. In contrast to private insurance, determining Medicaid eligibility can be complex and the application process daunting, advocates say. A patient’s medical condition also may keep families from applying promptly for coverage.
All four states — New Hampshire, Indiana and Arkansas, in addition to Iowa — have expanded Medicaid under the federal health law, which allowed states to include in their Medicaid program adults with incomes up to 138 percent of the federal poverty level, or about $16,000 for one person.
In theory, most adults are required to have insurance under the ACA.
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