The Medicaid expansion to cover nearly all low‐income individuals up to 133% of the poverty level ($14,404 for an individual in 2009) is the foundation for coverage in the new health reform law. Prior to reform, states could only cover non‐disabled adults without dependent children through a Medicaid waiver or fully state‐funded program. Expanding Medicaid to newly eligible childless adults will be among the key issues in implementing health reform. Based on interviews with officials in seven states and the District of Columbia and national experts, this report provides lessons learned to help inform reform expansion efforts as well as profiles of programs included in the study. Key findings include:

• Historic lack of eligibility for Medicaid, limited connection to public programs, fluctuating incomes, and language and cultural barriers all serve as challenges to reaching and enrolling childless adults.
• Many best practices for enrolling parents and children in Medicaid and CHIP will apply to childless adults, but reaching these adults will also require new outreach strategies and messages.
• More needs to be learned about the health needs of low‐income childless adults and how to best deliver and manage their care.

Health reform will expand Medicaid to millions of low‐income adults, including childless adults who have historically been ineligible for the program, necessitating one of the largest enrollment efforts in the program’s history.

Full report: Expanding Medicaid to Low-Income Childless Adults under Health Reform: Key Lessons from State Experiences (PDF | 665.6 KB)