Medicaid Eligibility in 2014 under ACA

[kevink]

I get the impression that many on this board have incomes even in retirement that render this moot, but am wondering if there are any others who like us are living entirely off of investments and have low enough taxable incomes to be eligible for Medicaid in 2014 when all of the ACA provisions kick in.

We're a couple, no kids, and thanks in part to the low capital gains rates in recent years haven't even come close to 10K in taxable income in years now. According to the Kaiser calculator:

Health Reform Subsidy Calculator - Kaiser Health Reform

and other tools I've looked at we'd be able to drop private health insurance, use Medicaid for catastrophic coverage and pay out-of-pocket for basic care as we've been doing for years anyway with high-deductible bare-bones policies. There's no means testing for Medicaid eligibility under ACA, though I gather some states may impose that. Any thoughts welcome and appreciated.

 

[MichaelB]

A few people have expressed interest. Much depends on the decision to expand Medicaid, which is a State choice. A couple of threads on this

http://www.early-retirement.org/forums/f28/health-insurance-subsidy-calculator-63122.html

http://www.early-retirement.org/forums/f38/implications-of-aca-for-low-budget-er-62300.html

It appears States will determine Medicaid eligibility as they do now.

 

[plex]

Yup, it is something I will need to keep heavily in mind when I retire, because I will need to generate enough income through 72t's, Roth conversions, and dividends in taxable accounts so that I either don't end up in a dead zone, or end up on Medicaid when I'd rather be on a gold plan in the exchange.

As mentioned it depends on your state, if the state participates, at 0-133% is Medicaid. If the state doesn't participate, between 0-100% is a dead zone where you have to self insure, and 100-400% is the exchanges, with 100-133% being even more heavily subsidized than at the normal start of 134% in Medicaid states.

Honestly controllable in any state regardless, just need to be aware of it, because it involves a heck of a lot of money.

 

[kevink]

From the looks of it more and more states are realizing they can't afford to leave that much money on the table and are expanding eligibility (even Arizona, our retirement destination). The key issue for low-budget ER types like myself is clearly the absence of means testing for Medicaid eligibility under ACA. This means a reasonably healthy person could use Medicaid as their catastrophic coverage and pay out of pocket - until reaching age 65 of course at which time presumably the usual draconian asset tests kick in.