It goes without saying that people on Medicaid don't earn much money. While state programs' health benefits differ from state to state, all must have very low co-pays and deductibles to earn the federal match. The same will be true for those states that expand their Medicaid programs to cover people earning up to 138% of the poverty level.
The CMS is considering an Arkansas proposal to use its Medicaid expansion money to subsidize purchase of individual insurance coverage on the state's exchange. A CBO report concluded that buying private plans would cost the federal government a lot more than simply expanding Medicaid.
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