? about ACA insurance to Medicaid transition

[Mr. Green]

Our first child was born a few weeks ago so I've been dealing with the health insurance update that needs to happen. My wife and I have been on private insurance plans through the ACA up until now. Based on our income, I expected our daughter to qualify for Medicaid. I did not expect them to say my wife also qualifies for full Medicaid. I still don't understand how this is possible because the information on our state's Medicaid website doesn't indicate any program my wife would qualify for at our income level but this is what our caseworker is telling me.

Apparently, there is a look-back period where Medicaid will cover bills within the last 60 days or something like that. My concern is what happens to ACA subsidies from the last couple of months if we're learning after the fact that Medicaid will cover her for that time. The subsidies are significant so I'm concerned that at the end of the year she will have been deemed ineligible for subsidies for those months. Has anyone else gone through something like this and can comment about how this ultimately plays out?

[less4success]

I have no experience with this, but was curious and stumbled upon this article that seems relevant:

https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/im-low-income-and-enrolled-in-subsidized-marketplace-coverage-now-i-just-found-out-im-pregnant-under-my-states-rules-i-now-qualify-for-medicaid-do-i-have-to-drop-out-of/

Edit: they don't link to the specific rule, but they're claiming you can choose either your marketplace insurance or Medicaid without impacting subsidies. I think KFF is a reliable source of information, but I have no way of determining if this page is up to date.

[Mr. Green]

My surprise is that my wife is no longer pregnant. When I used the healthcare.gov estimate tool it said that both my wife and I would be on private insurance and our child would be on Medicaid but when I officially updated our application it said my wife may qualify for Medicaid too. Unfortunately, our county caseworker hasn't been the most helpful so I'm still having a hard time figuring out what it is that is causing my wife to qualify. I've been told it can take up to 45 days for the Medicaid process to complete, so while I've been told both my wife and child are approved we have no information beyond that yet. Meanwhile, there are doctors appointments for both of them and I guess we just keep giving them our private insurance info for now? So far my wife's private insurance is still active but all we can tell our pediatrician and hospital is that our daughter has been approved for medicaid. It just seems like this could turn into a real mess.