I know, suddenly it’s all health care all the time with me. But the Medicaid Expansion was completely off my radar, and I’m learning. It’s also suddenly more of a state issue than it was before the Supreme Court decision because the court made the expansion much less compulsory.
The Urban Institute has a helpful paper (pdf) on how failure to adopt the expansion would affect health care for people making 138% of the federal poverty level or less. The scheme of the health care reform bill pretty well assumed this expansion of the Medicaid system. So, in those states that opt out, there are some pretty dramatic holes. Apparently those at poverty level up to 138% might be eligible for some subsidies if the extension isn’t adopted. But people below the poverty level but not eligible for Medicaid under the current scheme are in bad shape.
They give some numbers for Indiana: 410,000 below the poverty line; 108,000 between the poverty line and 138% of the poverty line; 517,000 affected by the Medicaid expansion; 947,000 uninsured and 54.6% of the uninsured are potentially Medicaid eligible under the expansion.