People below the poverty level will have no new coverage options under the Patient Protection and Affordable Care Act in states that don’t expand their Medicaid programs, according to a new study.
As many as two of five recently uninsured adults in those states likely will have no new affordable health insurance options next year, says a new Commonwealth Fund report.
That’s because 26 states have decided either not to expand their programs or remain undecided, meaning many below the poverty line won’t have access to either the Medicaid expansion or subsidized private insurance through the new state insurance marketplaces and probably will remain uninsured.
“If states don’t expand their Medicaid programs, adults with the lowest incomes will continue to live without the health and financial security provided by the Affordable Care Act,” Commonwealth Fund vice president and study coauthor Sara Collins explained.
Beginning next year, under PPACA, people earning less than 133 percent of the federal poverty level will qualify for Medicaid. But because of the way the law was written, people making between 100 percent and 133 percent of the federal poverty level are eligible to purchase subsidized insurance coverage through the state marketplaces if they aren’t eligible for Medicaid.
But people making less than 100 percent of the poverty level are not eligible for marketplace subsidies, since it was assumed they would be enrolled in Medicaid, not anticipating the Supreme Court decision upholding the Affordable Care Act would make Medicaid expansion optional for states.
Study authors urged Congress to pass a bill allowing people below the poverty line ineligible for Medicaid to gain subsidized coverage on the new insurance exchanges.
Commonwealth Fund President David Blumenthal said he’s optimistic other states will back Medicaid expansion later on, but “for states that don’t, it will be crucial for federal policymakers to look into legislative fixes that will allow the lowest-income residents in those states to purchase subsidized health insurance through their state marketplaces so they can benefit, like their better-off neighbors, from the protections available through the Affordable Care Act.”