States Deliberately Leave Millions of the Poor Uninsured

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Even though the federal government would have picked up 90 percent of the bill for Medicaid expansion under Obamacare in future years, half the states have refused to expand the program. has been plagued with sign-up glitches. After three weeks, the site isn’t working much better than the rocky start we documented on Day One of the state health insurance marketplaces run by the federal government.

President Obama has a team working to fix the website, NPR says. Unfortunately, millions of Americans waiting to sign up are going to find even more bad news when they finally make it through the system: They aren’t eligible for coverage.

The original plan for the Affordable Care Act was that nearly everyone who doesn’t have insurance through their workplace could purchase private health insurance through the online insurance marketplaces (often with a federal subsidy) or qualify for Medicaid if they were low-income.

“Currently in most states you have to be a child, pregnant or disabled to get Medicaid,” NPR says. “The health law was supposed to change all that — expanding the program to include nearly everyone with incomes up to about 133 percent of the federal poverty level, or about $15,000 a year for an individual.”

However, the U.S. Supreme Court’s health care decision threw a wrench in the works. The court’s majority opinion said that it was up to each state to decide whether or not Medicaid would be expanded.

Only half the states have so far decided to do so, “even though the federal government is paying the entire cost of the additional people for the first three years, and 90 percent going forward,” NPR says.

That will leave an unexpected 6 million to 7 million low-income adults without many options; you can’t even qualify for insurance on the marketplaces without income above the poverty line.

Not sure if your state is expanding Medicaid or not? The Kaiser Family Foundation has a chart documenting the position of each state and Washington, D.C.

The uninsured will likely rely on community clinics and public hospitals, NPR says, but those places are likely to become even more overwhelmed than they already are. Again, the health care law assumed these people would get coverage — so it reduced funding for public hospitals to save money.

Do you think Medicaid should be expanded in every state? Why or why not? Comment below or on our Facebook page.

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