Glossary

categorical eligibility

Medicaid’s eligibility pathway for individuals who can be covered. The program’s 25+ categories have been organized into five broad groups – children, pregnant women, adults in families with dependent children, individuals with disabilities and the elderly. In states that elected to expand their Medicaid programs, the Affordable Care Act (ACA) broadened Medicaid eligibility to all individuals under age 65 with incomes up to 133 percent of the federal poverty level and who are not eligible for Medicare. (See Medicaid and CHIP chapter.)