LEFT ON THE PAVEMENT: Millions left uninsured after Medicaid left unexpanded by several states
People making less than $11,500, without medical insurance made ineligible for Medicaid expansion
It's been an especially rough week for the poor, unemployed and uninsured. A chasm has been rendered in insurance coverage that sweeping legislation, "health care reform," will do nothing to fix. This, in spite of the promise to provide millions of Americans with affordable health care.
According to data analysis released by The New York Times, these people live in states that have refused extensions to Medicaid, which is the national health insurance program for the poor.
Twenty-six states currently, all with Republican governors or Republican-controlled legislatures have to date declined Medicaid expansion, leaving the health care situation of millions of uninsured people unchanged.
In the 24 remaining American states, including Washington, D.C., continue to proceed with Medicaid expansion. More than 8.7 million people are expected to be newly enrolled, according to the Centers for Medicare and Medicaid Services.
The newspaper analysis says that while the 26 states that declined Medicaid expansion represent approximately half of the national population, the states include an unusually high percentage - 60 percent, of the uninsured working poor and 68 percent of uninsured African-Americans and single mothers.
Under the terms of the ACA, Medicaid coverage was intended to be expanded to all adults with incomes up to 138 percent above the federal poverty line, which amounts to $15,856 for an individual. These funds would be covered by the federal government at 100 percent of cost until 2016, and at 90 percent thereafter.
A U.S. Supreme Court ruling, however on the ACA in June 2012, stated that the federal government was barred from mandating states to enact Medicaid expansions. As a result, an insurance coverage gap currently exists where millions of people making less than $11,500 per year or $23,500 for a family of four will have too much income to qualify for Medicaid - but not enough to receive federal subsidies when purchasing insurance on a state-run health exchange.
"They are simply out of luck in those states," Stephen Zuckerman, a health economist with the Urban Institute says. "The law was written in a very structured way" in which the gulf between the poor and those who qualify for federal subsidies should have been covered by Medicaid expansion.
But as a result of the Supreme Court decision, a counter-intuitive panorama has emerged where "their incomes are not high enough for them to get help," Zuckerman says.
HealthCare.gov, the new Web site set up by the federal government to explain the implementation of the ACA, admits that there isn't too much an individual or their families can do in those states without expansions.
While encouraging people to check if they are covered by an existing state Medicaid policy, the Web site says the federal government can do little for those caught in a coverage gap absent new state policies. "States are continuing to make coverage decisions and they could expand Medicaid in the future," the Web site says.
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