That's an income test, not an expense test, and mustachianism isn't predicated on limiting your income.
It looks to me like Medicaid eligibility is determined once per year, and good for 12 months. I think they're just going to pull your most recent tax forms and look at your MAGI.
Which is easy to game. There are lots of ways to get your MAGI down pretty low, depending on how you structure your investments. Between retiring and reaching Medicare eligibility age, I expect most of my expenses to come out of "income" that would never show up on my tax forms, such as Roth IRA withdrawals, drawdowns on taxable investment accounts, or annuities.
If the market goes crazy one year and I wasn't eligible, I can always get insurance on my state exchange. Looking at the projections for Washington State is very encouraging, I expect to pay less per month as an unemployed early retiree than I do now as a worker with an employer who covers most of my health insurance costs. The ACA seems to guarantee that I can float back and forth between types of coverage at will, without being denied eligibility for a gap in coverage.
Of course, if you fall below 125% of the poverty line you will be eligible only for Medicaid, not for the marketplace subsidies.
Right, but even if I'm above the 138% FPL cutoff for Medicare, I still expect to be comfortably below the 400% FPL cutoff for marketplace subsidies. That's over $94k/year in MAGI for a family of four. If you can't stay under that, you probably don't belong on this website.
Private insurance will almost certainly be better than Medicaid, though Medicaid is better than no insurance for sure.
This is really what I was asking about. Why is Medicaid not as good as private insurance? What are the drawbacks? It seems to cover all the same stuff (preventative visits, hospitalizations, prescription drugs, ER) and some stuff that some regular insurance doesn't (vision, long term care).