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How Obamacare works is that if your income is sufficiently low, then you can get Medicaid. And if your income is too high to be eligible for Medicaid, then you'll get a Premium Tax Credit (aka the Subsidy) which you can use to buy private health insurance through Healthcare.gov. I live in New Jersey, where if your income is between 0 and $16,643, then you're eligible for Medicaid, and thus if your income is above $16,643 you're eligible for the Premium Tax Credit.

Now I have the ability to structure my income so that it's either below $16,643 or above $16,643. In one case, I would be eligible for Medicaid, and in the other case, I would be able to get a Silver plan on Healthcare.gov for free through the Premium Tax Credit.

So my question is, how does Medicaid compare with the private insurance plans on Healthcare.gov? Is it as good as a Gold plan, a Silver plan, a Bronze plan, or none of the above? Would it be harder to find doctors, hospitals, etc. that accept Medicaid compared to those who would accept a private insurance plan? I suppose that would depend on the Medicaid reimbursement rate, which varies from state to state, so again I'm from New Jersey.

EDIT: My situation has changed somewhat: I no longer have the ability to structure my income so that it's either above or below the $16,643 threshold. Now my income is definitely going to be less than $16,643, which means I am ineligible for Obamacare subsidies. So now my choices are either get Medicaid, or buy private insurance for full price on healthcare.org.

EDIT: This question is moot now, as I ultimately decided to get Medicaid.

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    The biggest thing to look out for is provider availability in the networks and prescription drug formulary. In some states the individual exchange plan networks are roughly the same as medicare and use roughly a medicare size formulary. There's more to this than how much the deductible is.
    – quid
    Commented Feb 27, 2017 at 18:40
  • @quid Well. I live in New Jersey, so can you give me specific information for New Jersey?
    – Keshav Srinivasan
    Commented Feb 27, 2017 at 18:41
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    Medicaid would likely be a big change for you. As far as process goes you'll likely be more comfortable just getting a plan from the exchange. Diabetes isn't an obscure condition and a lot of relevant meds are mandated to be included. My point is really just that the differences between group coverage, individual coverage, exchange coverage, and medicaid are more than just the copays and deductible(s).
    – quid
    Commented Feb 27, 2017 at 19:06
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    Might want to consider whether you're going to regularly be in this income range or if you're going to be out of it (too high) very soon. If you're going to be in the Medicaid range for a while, then might be easier to stay with it (as I wouldn't assume that subsidy is something you'll get in the future). If you're going to be higher very soon, might want to consider non-Medicaid, some plan that's more similar to what you will likely want to have in the future, so you don't have to change doctors.
    – Joe
    Commented Feb 27, 2017 at 19:13
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    @KeshavSrinivasan - I should have said "not viable for most people." It's not out of the question that paying full price for an exchange plan would be preferable over Medicaid, but it seems unlikely unless you have something specific in mind that is covered only by the exchange plan. Instead, comparing just above or below the threshold certainly would be more useful information for most people, and having that information would make it easier for you to extrapolate for your specific situation of paying full price.
    – TTT
    Commented Mar 15, 2017 at 16:53

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