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Republicans’ refusal to fully implement the Affordable Care Act will leave more than half of the nation’s uninsured working poor, approximately 8 million people, without access to health insurance, a New York Times analysis of census data finds. The 26 GOP-controlled states not participating in the law’s Medicaid expansion are home to a disproportionate share of low-income Americans who aren’t poor enough to qualify for the existing Medicaid program and make too much to be eligible for subsidies in the ACA’s insurance marketplaces.
As a result, hundreds of thousands of cashiers, cooks, nurses’ aides, waiters and waitresses will still struggle to afford coverage.
“Blacks are disproportionately affected, largely because more of them are poor and living in Southern states,” the New York Times reports. “In all, 6 out of 10 blacks live in the states not expanding Medicaid.” From the NYT:
The gap is the result of a 2012 Supreme Court ruling that upheld the constitutionality of the ACA’s individual mandate, but permitted states to refuse to expand Medicaid. Many of the states that turned down the program — Texas, Louisiana, Florida, South Carolina, Mississippi, and Georgia — already suffer from the highest uninsured states in America and are less likely to provide government assistance in obtaining insurance than states that have agreed to increase Medicaid eligibility. Under reform, adults who earn less than the federal poverty line will still lack affordable coverage options, while individuals and families above the threshold will be eligible to purchase subsidized coverage in the law’s new health care marketplaces.
Republicans argue that expansion would cost their states millions, even though the federal government will pick up nearly all of the costs of coverage (100 percent for the first three years, phasing down to 90 percent in 2020 and all subsequent years), paying nearly 93 percent the cost over the next nine years, according to the Congressional Budget Office.