15 Million Affected by States Opting Out of Medicaid Expansion

Tuesday, 25 Mar 2014 10:02 AM

By Melissa Clyne

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The 23 states refusing to expand Medicaid are home to more than 15 million uninsured and underinsured people living below the poverty line, The Hill reported, citing a study by the Commonwealth Fund.

The states, highly clustered in the South and most with Republican governors and legislatures, have refused to accept federal money to expand Medicaid, arguing that they are skeptical of the federal government’s promise to pay 100 percent of the expansion costs for the first year and up to 90 percent afterward. States would be decimated by expanding Medicaid rolls without federal dollars, they say.

As a result, 15 million Americans don’t qualify for either Medicaid or federal healthcare subsidies, rendering them unable to afford health insurance.

"The vast majority of people struggling to afford healthcare are low- and middle-income, and exactly the people the Affordable Care Act was designed to help," Commonwealth Fund Senior Vice President Cathy Schoen said in a statement.

"This report demonstrates that the health reform law was accurately targeted toward the needs of the uninsured and underinsured," Schoen said. "However, if all states don’t expand Medicaid, millions will still go without health insurance and healthcare."

Obamacare creators drafted the law under the assumption that all states would expand Medicaid. The U.S. Supreme Court ruled in favor of the states, saying they could opt out.

In states with expanded Medicaid coverage, according to Forbes, those with incomes up to 133 percent of the federal poverty level – $15,521 for an individual and $31,721 for a family of four – are eligible for Medicaid.

Forty percent of Texans are uninsured or underinsured, with other opt-out states such as Florida, Georgia, North Carolina, and Louisiana close behind, according to The Hill.

The decision by opt-out states has thrown the Obama administration and liberal-leaning advocacy groups into a tailspin.

MoveOn.org has announced a six-figure "billboard advertising blitz" in Texas, Florida, Wisconsin, Nebraska, Louisiana, and Virginia – urging them to "accept federal Medicaid funds, which would allow them to extend health coverage to more than 2 million Americans," according to Forbes.

Health and Human Services Secretary Kathleen Sebelius has publicly chastised Republican governors, accusing them of "playing politics with people’s lives," The Hill reported.

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