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States Shouldn’t Deny Low-Income Adults Access to Medicaid

Very low-income uninsured people with significant health care needs could be left without access to health insurance because their states’ governors are refusing to expand Medicaid under the Affordable Care Act (ACA), as a recent Associated Press article describes.

Under the ACA, states have the choice of expanding Medicaid to cover low-income adults with incomes up to 133 of the federal poverty line, with the federal government paying for nearly all of the cost.  Governors in Florida, Texas, Louisiana, and several other states have rejected the Medicaid expansion, in some cases relying on flawed estimates that overstate the financial impact on their states, as I’ve


Many people recognize Medicaid as a program that provides health coverage to the poor, but few know that millions of adults don’t currently qualify for Medicaid — even if they have little or no income.  That’s because most states don’t cover adults without dependent children, regardless of how low their incomes are.  All states cover low-income parents, but in the median state, the income cutoff to qualify for Medicaid for a working parent is 63 percent of the poverty line (about $12,000 for a family of three), and a non-working parent can’t have income of more than 37 percent of the poverty line (about $7,000 for a family of three).  In Louisiana, where Governor Bobby Jindal opposes the expansion, a parent can’t qualify for Medicaid if his or her household’s income exceeds just $4,800 a year.

More than 11 million poor, uninsured adults would be unable to get any help securing health coverage if their states do not expand Medicaid, according to the Urban Institute.  States shouldn’t leave these people out in the cold.  As we’ve shown, the Medicaid expansion is a very good deal for states, and it will provide much-needed help to their low-income, uninsured residents who can’t afford to buy coverage on their own.