eligible individual

(1) In general In this section, the term “eligible individual” means, with respect to any State, an individual— (A) who a resident of the State who is not eligible to enroll in the State’s medicaid program under title XIX of the Social Security Act [ 42 U.S.C. 1396 et seq.] for benefits that at a minimum consist of the essential health benefits described in section 18022(b) of this title ; (B) whose household income exceeds 133 percent but does not exceed 200 percent of the poverty line for the size of the family involved, or, in the case of an alien lawfully present in the United States, whose income is not greater than 133 percent of the poverty line for the size of the family involved but who is not eligible for the Medicaid program under title XIX of the Social Security Act by reason of such alien status; (C) who is not eligible for minimum essential coverage (as defined in section 5000A(f) of title 26 ) or is eligible for an employer-sponsored plan that is not affordable coverage (as determined under section 5000A(e)(2) of such title); and (D) who has not attained age 65 as of the beginning of the plan year. Such term shall not include any individual who is not a qualified individual under section 18032 of this title who is eligible to be covered by a qualified health plan offered through an Exchange.

Source

42 USC § 18051(e)(1)


Scoping language

In this section
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