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Few Options for Working Poor in States that Block Medicaid Expansion

John Commins, for HealthLeaders Media, September 6, 2013

Adults earning below the federal poverty level who live in the 26 states that have either rejected Medicaid expansion or have yet to commit to it will be ineligible for a federal subsidy to help them buy coverage on the health insurance exchanges.

Many working poor who live in states that won't expand Medicaid also won't be eligible for federal subsidies that would make private health insurance affordable.

A Commonwealth Fund study released this week estimates that a glitch in the implementation of the Patient Protection and Affordable Care Act was created when the U.S. Supreme Court ruled last year that the Medicaid expansion was optional for states. Even with the ruling, no one foresaw that some state would actually reject the billions of federal dollars to prop up the expansion.

However, 42% of adults who've been recently uninsured and who live in the 26 states that have either rejected Medicaid expansion or have yet to commit to it will be ineligible for a federal subsidy to help them buy coverage on the health insurance exchanges.

In those states, the study says, the lowest-income adults—those earning below the federal poverty level, or less than $11,170 for an individual and $23,050 for a family of four in 2012—will not have access to either the Medicaid expansion or subsidized private insurance through the new state insurance marketplaces and are likely to remain uninsured.

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1 comments on "Few Options for Working Poor in States that Block Medicaid Expansion"


Phyllis Kritek (9/6/2013 at 5:16 PM)
Thank you for disseminating the work of the Commonwealth Fund. Their work on the ACA provides some of the most in depth comprehensive analysis available, and emerges from a place where health care is itself a value, rather than merely a commodity. I'd like to think that the definition of poverty you share with your readers would itself be unsettling to health care providers. That we would, as a society, knowingly withhold health care from these, the least fortunate among us, stuns me. The 40 House votes to repeal the ACA without offering an alternative is not a statement about political ideology; it is a statement about moral choice.