Obamacare’s Medicaid gap still leaves millions uninsured as enrollment hits 2.5mn

Obamacare’s Medicaid gap still leaves millions uninsured as enrollment hits 2.5mn
About 2.5 million new people have signed up for health insurance during the Affordable Care Act’s latest open enrollment period, but a US Supreme Court ruling and state opposition to expanding Medicaid means many Americans will remain without healthcare.

Before the passage of the Affordable Care Act, more than 41 million Americans were without health insurance in 2013, according to Kaiser Family Foundation. One year into the ACA marketplace’s existence, the Commonwealth Fund found that 9.5 million more Americans gained health coverage. Despite this drop, millions remain unable to afford the premiums available on exchanges and they don’t qualify for Medicaid in states that chose not to expand the program. Others, meanwhile, don’t work enough to qualify for insurance through their employer.

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In 2012, the Supreme Court determined Medicaid expansion as written in the Affordable care Act couldn not be forced on states, allowing them to decide whether to expand coverage or not. Twenty-seven states have expanded Medicaid, plus the District of Columbia, but 21 states have not and two are debating the matter.

Since the Medicaid expansion was meant to cover people too poor to qualify for premium subsidies, those living in states that opted out of the program have few options available to them. The resulting “Medicaid gap” means millions of working Americans cannot get insurance.

Two-thirds of the people who fall into the gap are in a working family,” said Rachel Garfield, senior researcher for the Kaiser Family Foundation, to US News & World Report. “They are just working in jobs that don’t offer affordable health insurance coverage.”

The Kaiser Family Foundation estimates the average bronze Marketplace plan costs $224 a month in 2014 – that represents 25-50 percent of the monthly income of people who fall into the gap.

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Garfield thinks 4 million people are in this situation. They would be eligible for Medicaid had their state expanded the program, but they’re not eligible for anything else.

Most them are adults without children, 86 percent live in the South, over half are middle-aged or older and minorities are disproportionately represented. Also they work,” Garfield told the news outlet.

Some state governors who have held out on expanding Medicaid are now reconsidering their opposition. Since the midterm elections, Utah and Wyoming have decided to expand the program, and Tennessee Gov. Bill Haslam announced his state will expand it as well.

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Consulting firm Avalere Health told US News & World Report that they project 10.5 million people will have health insurance on the exchanges by the end of 2015 — more than the federal government's projection of 9 million. People have until Feb. 15 to enroll in coverage on the federal exchanges.