In 2014, Mary, an asset-wealthy individual, will qualify for Medicaid ahead of Bob, a needier individual with less net wealth and significantly higher medical costs, solely because Bob’s income is slightly higher. The current income-based eligibility standards for Medicaid mandated by the Patient Protection and Affordable Care Act (PPACA) do not adequately reflect an individual’s need for federal assistance because they neglect to consider an individual’s assets, debts, and the circumstantial cost of their healthcare. Thus, these new federal standards permit significant disparities in the treatment of similarly situated impoverished individuals and allow prioritization of asset-wealthy individuals over their more needy counterparts.

An individual’s ability to afford marketplace products like healthcare depends on more than just income. Relying upon need-calculation methodologies analogous to those used in determining eligibility for federal student aid would more successfully deliver adequate and wide-reaching health care benefits to impoverished populations. Such methodologies consider income, assets, and costs to more accurately reflect an individual’s ability to afford healthcare costs within their comprehensive life circumstances.