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Medicaid
Although Medicaid is generally beyond the scope of this report, ACA's Medicaid expansion
provisions have the potential for affecting eligibility for premium credits if certain low to middle
income individuals and families seek health insurance through the exchanges. Under ACA, states
have the option to expand Medicaid eligibility to include all non-elderly, non-pregnant
individuals (i.e., childless adults and certain parents, except for those ineligible based on certain
noncitizenship status) with income up to 133% FPL.27 (ACA does not change noncitizens'
eligibility for Medicaid.28) States that choose to implement the ACA Medicaid expansion will
receive substantial federal subsidies. If a person who applied for premium credits in an exchange
is determined to be eligible for Medicaid, the exchange must have them enrolled in Medicaid.29
Therefore, any state that expands Medicaid eligibility to include persons with income at or above
100% FPL (or any state that currently includes such individuals) would make such individuals
ineligible for premium credits.24