Without Obamacare’s Optional Expansion, Medicaid Has Serious Coverage Gaps

The Medicaid program that provides low-income Americans with public health insurance has serious coverage gaps across states, a new report from the Kaiser Family Foundation finds.

Obamacare seeks to raise each state’s Medicaid’s eligibility level from about $19,000 a year for a family of three — the current federal poverty level — to 133 percent of that rate, which is about $24,000 for a family of three. If all 50 states choose to opt into the expansion, which the federal government will completely fund for the first several years, about 17 million additional low-income Americans who currently fall between that gap will become eligible for Medicaid coverage. But if states stick with the status quo instead, they will perpetrate a fractured system that fails to reach all of the nation’s poor, according to the report’s findings:

Eligibility for parents was limited on average to those earning no more than 61 percent of the federal poverty line, which equals about $19,000 a year for a family of three. Thirty-three states required parents to earn less than the poverty rate, with 16 restricting eligibility to less than 50 percent.

Nine states extended full Medicaid coverage to adults without dependent children while three states, Hawaii, Illinois and Minnesota, reduced eligibility for adults where it was not required by federal rules.

Medicaid, which is run by states but has federal funding and oversight, represents a major budget expenditure for state governments. Many have sought to curtail benefits and eligibility in recent years because of fiscal constraints imposed by the recession and a slow economic recovery.

Nonetheless, Republican opponents of Obamacare represent a roadblock to extending health coverage to American families whose incomes fall well below the poverty line. Just four GOP governors have agreed to expand Medicaid under the health reform law, while more than a dozen Republican leaders have refused the expansion.

But fortunately for the low-income Americans who don’t currently qualify for Medicaid, the Republican resistance to Obamacare may finally be waning. GOP leaders presented a united front against Obamacare just two months ago, but the fact that some staunchly conservative politicians like Arizona Gov. Jan Brewer (R) are now agreeing to move forward with the Medicaid expansion suggests that Republicans may not continue to reject health reform at all costs. “The arc of partisan fever is beginning to recede and pragmatism is beginning to come to the fore,” Larry Jacobs, the director of the Center for the Study of Politics and Governance at the University of Minnesota, told Kaiser Health News.