Nineteen states are holding out against expanding Medicaid, manyRepublican-controlled — but their tough position could cost morethan 600,000 veterans' health coverage.

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NBC News reports that an Urban Institute study found that 604,000veterans are in the so-called“Medicaid gap” — they make too much money to get federal subsidiesto buy health coverage on the Affordable Care Act exchanges, butthey’re not poor enough to qualify for Medicaid, either.

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In addition, researchers said that those veterans don’t all getor qualify for care from the Department of Veterans Affairs— which leaves them out in the cold.

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The report says in part, “Some uninsured veterans may qualifyfor VA [Veterans Administration] care, but not all take up theavailable coverage or meet the eligibility requirements, which arebased on service-connected disability status, veteran dischargestatus, income and other factors.”

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While it’s an improvement over 2014, when 700,000 veterans wereshut out of healthcare coverage, it’s by no means something to beproud of. And even in states that have expanded Medicaid, lots ofveterans will be in that gap — although states that restrict whocan and can’t qualify for Medicaid will be shutting out many moreveterans.

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The report says, “If Medicaid expansion decisions do not changebetween now and 2017, we project that approximately 604,000veterans will be uninsured in 2017 and that 54 percent will beliving in states that have yet to expand Medicaid.”

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While the ACA has benefited plenty of formerly uninsuredAmericans — the most recent Census Bureau data indicate that thepercentage of uninsured has fallen from 16 percent in 2010 to 9.1percent last year, and the Health and Human Services Departmentestimated that 20 million Americans became insured between 2010 and2016 — veterans have seen gains, too.

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“Between 2013 and 2015, the uninsured rate for nonelderlyveterans fell by an estimated 42 percent, declining from 11.9percent in 2013 to 8.5 percent in 2014, and falling further to 6.8percent in 2015, according to the National Health InterviewSurvey,” the Urban Institute study says, continuing, “Over thistime, veterans also experienced fewer unmet health needs,suggesting that increased coverage translated into improved accessto care.”

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But that doesn’t help the 600,000+ who won’t be covered in thestates that won’t expand Medicaid. Many people believe that allveterans are entitled to receive medical care through the VA, butthat’s not the case — and without Medicaid expansion, they’ll beout of luck.

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