Republican governors who refuse to expand Medicaid eligibility will leave over 5 million low-income Americans without basic health coverage, a new study reports.

Medicaid expansion is a core component of the provisions of the Affordable Care Act (ACA) of 2010. So far, only 25 states and the District of Columbia have elected to expand the program. The Kaiser Family Foundation released the study, which says that states that do not expand Medicaid will leave millions of uninsured adults without coverage.

According to the study, low-income adults with incomes above Medicaid eligibility levels but below the poverty line “may fall into a ‘coverage gap’ of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits.” Most of these citizens are “likely to remain uninsured.”

In 2012, a Supreme Court ruling made Medicaid expansion optional for states. Medicaid expansion under the ACA was intended to fill historical gaps in the program and could have provided health care coverage to millions of currently uninsured people.

In the past, Medicaid eligibility has generally been “restricted to low income individuals in a specified category, such as children, their parents, the aged, or individuals with disabilities.”

In most states, adults without dependent children were not eligible for Medicaid. Further, eligibility levels for parents were generally set very low and varied greatly across states. As a result, only 30% of poor nonelderly adults had Medicaid coverage in 2012, compared to 70% of poor children, and uninsured rates for poor adults (42%) were well over twice the national average (18%).

Current Medicaid eligibility rules, which vary state-to-state, set a high standard for those who may wish to enroll in the program, ThinkProgress reports. Low-income, working adults who do not have children don’t qualify for Medicaid coverage in many states, no matter how small their income.

A study released earlier this month by the Robert Wood Johnson Foundation finds that people living in GOP-led states whose lawmakers have refused to expand Medicaid eligibility will have far less access to public health care insurance programs and government subsidies than those in other states.

The report states that between 59 and 81 percent of uninsured residents living in states that have chosen to expand Medicaid under the ACA could qualify for programs like Medicaid, the Children’s Health Insurance Program, or ACA subsidies that would enable them to purchase private insurance.

Only 34 to 53 percent of those living in states not expanding Medicare eligibility could qualify for health care coverage.

More than one-third of Americans who won’t qualify for Medicaid or ACA subsidies live in Texas and Florida, two of the states whose governors oppose the Affordable Care Act, ThinkProgress reports. As of September, Texas had refused to participate in Medicaid expansion and Florida was leaning toward refusal.


Where the States Stand

Via: The Advisory Board Company

Alisha is a writer and researcher with Ring of Fire. Follow her on Twitter @childoftheearth.