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Current Events & Hot Topics Current Events & Hot Topics

States' Refusal To Expand Medicaid May Leave Millions Uninsured

Posted by on Oct. 23, 2013 at 11:27 AM
  • 32 Replies

States' Refusal To Expand Medicaid May Leave Millions Uninsured

4 min 48 sec



Protesters fill the Miami office of Florida state Rep. Manny Diaz Jr. on Sept. 20 to protest his stance against expansion of health coverage in the state.

Protesters fill the Miami office of Florida state Rep. Manny Diaz Jr. on Sept. 20 to protest his stance against expansion of health coverage in the state.

Joe Raedle/Getty Images

President Obama Tuesday appointed one of his top management gurus, Jeffrey Zeints, to head the team working to fix what ails Healthcare.gov, the troubled website that's supposed to allow residents of 36 states to enroll in coverage under the Affordable Care Act.

But even if the team gets the website working as it should, millions of Americans may still log on to discover that they aren't eligible for any health coverage at all. And that won't be due to any technical glitch. It's because their state has decided not to expand the medicaid program.

This is not the way the health law was designed and enacted, says Bruce Siegel.

"Originally the idea was that millions and millions of Americans would get health insurance," says Siegel, president and CEO of , a group that represents safety net institutions around the country. "They'd get coverage through Medicaid or through private insurance on the exchanges."

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

But in the summer of 2012, when the Supreme Court upheld the health law as constitutional, it did something unexpected, Siegel says. "They said or not expanding it. And that led to a very, very different landscape than what we expected."

Even to opt in, still only half the states have said they will expand their Medicaid programs, even though the federal government is of the additional people for the first three years, and 90 percent going forward.

As a result, according to the , between 6 and 7 million low-income uninsured adults live in states that are so far not expanding their programs.

And some of those states have among the largest populations of low income uninsured people.

"Over 3 million of them live in just four states," says Genevieve Kenney, senior fellow and co-director of the Urban Institute's Health Policy Center. Those states are Florida, Texas, Georgia and North Carolina.

The problem, says Kenney, is that for many of those people the law offers them nothing. Because they were supposed to get Medicaid, they're at the exchanges unless their incomes are above the poverty line. That's about $11,000 a year for an individual.

"I think it's going to be confusing for individuals who are applying for coverage," says Kenney. "It certainly makes the message about the new affordable coverage that's available a lot more complicated to target."

Among the people who could get left behind is Ellen Wall. She's a nanny and sometime music teacher from Atlanta. She says her income fluctuates, but most years it's right around the poverty line. She says as long as she can pay her bills, she doesn't mind earning that amount.

"I love doing what I do because I'm very good at what I do, that's why I've chosen this profession," she says. "But there are those years when it's quite lean and then I'm just barely making it. And what am I gonna do if something comes up and I'm really sick and I need some help?"

Wall doesn't have and hasn't had health insurance. She says that was a real problem a few years back when she was in the hospital after an asthma attack.

"It was kind of a very embarrassing situation to be in, not to have the health insurance that could have covered that few days that I was in the hospital," she said.

If Wall lived in a state expanding Medicaid she would clearly qualify. But so far, Georgia isn't. And her income may or may not be high enough to let her qualify for help buying private coverage on the state's exchange. So she'll likely remain working, poor and uninsured.

Most advocates say people like Wall should turn to community clinics and public hospitals if they can't get insurance. But there's a problem there, too, says public hospital advocate Siegel. The health law cut funding for public hospitals because it assumed so many more people would have insurance. But in those states that aren't expanding Medicaid, the need for free care is likely to go up instead of down.

"Many of these hospitals will be overwhelmed," Siegel says. "Some of them are already overwhelmed; many of them are already losing money, providing a high level of service to people in need. And this will simply not be a tenable position."

Public and other hospitals are in the states that so far have opted not to expand their Medicaid programs. Some states are still considering opting in. But in others, patients left behind may have to scramble even harder to find care if they get sick.

National Woman's Party


by on Oct. 23, 2013 at 11:27 AM
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Replies (1-10):
furbabymum
by Gold Member on Oct. 23, 2013 at 11:29 AM
1 mom liked this

 What's up with this article. Is it missing words or is the writer just this bad? I tried sticking it out but I couldn't. It's missing too much.

NWP
by guerrilla girl on Oct. 23, 2013 at 11:31 AM

I think it is possible that NPR uses a digital translator to convert their radio programs into text articles. I have noticed this a few times myself...They could do better. I suppose using a person to edit or create the transcripts has fallen victim to budget cuts. But this is just my guess...Most of the time I can follow what it says.

Quoting furbabymum:

 What's up with this article. Is it missing words or is the writer just this bad? I tried sticking it out but I couldn't. It's missing too much.


National Woman's Party


AdrianneHill
by Platinum Member on Oct. 23, 2013 at 11:32 AM
That'll show Obama! All of those uninsured people needing care and even fewer dollars to do it with but at least women with children over five won't have insurance. Health needs go away when the kids hit kindergarten
TigOlBitties
by Bronze Member on Oct. 23, 2013 at 11:33 AM
1 mom liked this
What?


Quoting AdrianneHill:

That'll show Obama! All of those uninsured people needing care and even fewer dollars to do it with but at least women with children over five won't have insurance. Health needs go away when the kids hit kindergarten

quickbooksworm
by Silver Member on Oct. 23, 2013 at 11:34 AM
They use a transcription service but people are not allowed to put in anything that is not there.


Quoting NWP:

I think it is possible that NPR uses a digital translator to convert their radio programs into text articles. I have noticed this a few times myself...They could do better. I suppose using a person to edit or create the transcripts has fallen victim to budget cuts. But this is just my guess...Most of the time I can follow what it says.

Quoting furbabymum:

 What's up with this article. Is it missing words or is the writer just this bad? I tried sticking it out but I couldn't. It's missing too much.



furbabymum
by Gold Member on Oct. 23, 2013 at 11:34 AM

 That would make sense!

Quoting NWP:

I think it is possible that NPR uses a digital translator to convert their radio programs into text articles. I have noticed this a few times myself...They could do better. I suppose using a person to edit or create the transcripts has fallen victim to budget cuts. But this is just my guess...Most of the time I can follow what it says.

Quoting furbabymum:

 What's up with this article. Is it missing words or is the writer just this bad? I tried sticking it out but I couldn't. It's missing too much.


 

NWP
by guerrilla girl on Oct. 23, 2013 at 11:36 AM

I've also noticed that some of the active link phrases do not copy/paste. Here is the original URL and it seems most of the missing text is there

http://www.npr.org/blogs/health/2013/10/23/239833838/states-refusal-to-expand-medicaid-may-leave-millions-uninsured

Quoting furbabymum:

 That would make sense!

Quoting NWP:

I think it is possible that NPR uses a digital translator to convert their radio programs into text articles. I have noticed this a few times myself...They could do better. I suppose using a person to edit or create the transcripts has fallen victim to budget cuts. But this is just my guess...Most of the time I can follow what it says.

Quoting furbabymum:

 What's up with this article. Is it missing words or is the writer just this bad? I tried sticking it out but I couldn't. It's missing too much.


 


National Woman's Party


quickbooksworm
by Silver Member on Oct. 23, 2013 at 11:36 AM
I think if your state has not expanded their Medicaid program to allow people to enroll, the individuals in that state shouldn't be penalized. Premiums for me and my son are more than my rent and that's ridiculous.
NWP
by guerrilla girl on Oct. 23, 2013 at 11:37 AM
1 mom liked this

I agree. I think these people should contact their representatives asap.

Quoting quickbooksworm:

I think if your state has not expanded their Medicaid program to allow people to enroll, the individuals in that state shouldn't be penalized. Premiums for me and my son are more than my rent and that's ridiculous.


National Woman's Party


stormcris
by Christy on Oct. 23, 2013 at 11:39 AM

I am curious then, if these people go to the exchange they are denied? or the exchange has a limit to the offset? It stated neither of these conditions in the bill or any formula program to check for cost since then.

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