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Medicaid expanded in some but not all states

Medicaid, although it is jointly funded by both the federal government and the states, varies from state to state. The Affordable Care Act or Obamacare was supposed to increase the availability of insurance coverage to the uninsured and poor and this was to be done primarily through Medicaid expansion throughout the states.

What is Medicaid and how do I qualify?

Medicaid is the federal health insurance program for low-income families and others in need. It is offered to most claimants who are getting Supplemental Security Income and low income families with dependent children. Under the new law, however, Medicaid, in states which chose to expand the program, will also start to cover many adults who do not have dependent children.

If all the states had chosen to expand Medicaid it would have expanded to an estimated 21.3 million people by 2022 (estimated provided by Kaiser Family Foundation). But even without the uniform expansion, more people will now qualify for Medicaid because the new healthcare law lowered the threshold for qualifying. For instance, now a single person earning $15,856 or a family of three earning $26,951 would qualify.

States choose not to expand Medicaid and win their case

Many states have chosen not to expand Medicaid coverage because although the federal government agreed to pay for some of the costs, some of the costs must be absorbed and paid by the states. And because many states felt like their state budgets could not afford the increase in Medicaid costs, they chose not to expand the program.

Under the new healthcare law the government initially tried to cut all Medicaid funding to states that did not expand the program. States fought back and sued the federal government. The government’s move backfired and the challenge went all the way to the United States Supreme Court.

The Supreme Court decided states did have the constitutional right not to expand Medicaid. In fact, they decided each state should be allowed to review their own budgets and make a sound financial decision for their state. The federal government did decided, however, that if a state chose to expand Medicaid they would receive additional funds.

A State-by-State Decision to expand Medicaid

As of September 2013, there are twenty-five states who have decided to expand Medicaid. Other states are still deciding and twenty-two states have decided not to expand their program.

States which have expanded Medicaid include Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Kentucky, Maryland, Iowa, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Dakota, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, Washington D.C., and West Virginia.

States which have decided not to expand Medicaid include Alabama, Alaska, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, North Carolina, South Dakota, Texas, Utah, Virginia, Wisconsin and Wyoming.

Three states are still deciding whether or not to expand Medicaid coverage: New Hampshire, Ohio, and Tennessee.

Expanding Medicaid, however, is only part of the battle. If we have insufficient medical doctors to service the patient load or the premiums paid to doctors are too low, it won’t matter whether or not states expand coverage or not, there won’t be enough doctors to provide medical care to the new patients.
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