About Joanne Kenen
Contributing editor to Politico Magazine and former health care editor-at-large, Politico, Commonwealth Fund journalist in residence and assistant lecturer at Johns Hopkins Bloomberg School of Public Health.
Ron Jackson of Oklahoma Watch wrote one of the best stories I’ve seen laying out the policy dimensions and the human face of the decision by some states to forgo Medicaid expansion.
You’ll recall, of course, that when the Supreme Court upheld the Affordable Care Act it made the Medicaid expansion a state option, not a requirement.
That created an anomaly that the law’s authors did not intend: People with incomes at the poverty level and up to four times the poverty level (roughly $92,000 for a family of four) will be able to get subsidized insurance in the state-based health exchanges starting in 2014. But people who are poorer than that – who are below the poverty level and who are not now eligible for Medicaid in their state (which is way more restrictive than most people imagine) won’t get subsidies.
If their state doesn’t expand Medicaid, they get nothing.
Oklahoma is among the states rejecting the coverage expansion – saying it will leave them on the hook for untold millions of dollars, even though the federal government has promised to pick up the full cost for three years and 90 percent over the long haul.
Jackson described what that means to “tens of thousands of low-income parents.” Continue reading →
