Under President Obama's Affordable Care Act people of America will receive subsidies so that they can buy health insurance, at the same time millions of poor will be without any health insurance as many states refuse to expand Medicaid.
Some of the states - Texas, Florida, Kansas, Alabama, Louisiana, Mississippi and Georgia refuse to expand their Medicaid program. More Than half the people without insurance live in these states.
AdvertisementSandy Praeger, the insurance commissioner of Kansas, said she would help consumers understand their options. She said, however, that many of "the poorest of the poor" would fall into a gap in which no assistance is available.
After seeing advertisements which promote health insurance options, they will learn they are ineligible only when they apply. Federal officials felt that the disturbed consumers would blame the health law and the President rather than their Governors like Rick Perry of Texas or Bobby Jindal of Louisiana.
According to a Supreme Court ruling last year, the states could opt for expansion and it was not mandatory. Some Governors like Rick Scott of California, though in favor of expansion was out voted by state legislators.
Bee Moorhead, the executive director of Texas Impact, an interfaith group that favors the expansion of coverage, said: "A lot of people will come in, file applications and find they are not eligible for help because they are too poor. We'll have to tell them, 'If only you had a little more money, you could get insurance subsidies, but because you are so poor, you cannot get anything.'
"That's an odd message, a very strange message. And if people are sick, they will be really upset."
In Atlanta, Amanda Ptashkin, the director of outreach and Georgians for a Healthy Future said: "Hundreds of thousands of people with incomes below the poverty level would be eligible for Medicaid if the state decided to move forward with the expansion of Medicaid. As things now stand, they will not be eligible for anything. What do we do for them? What do we tell them?"
Bruce Lesley, the president of First Focus, a child advocacy group, said: "In states that do not expand Medicaid, some of the neediest people will not get coverage. But people who are just above the poverty line or in the middle class can get subsidized coverage. People will be denied assistance because they don't make enough money. Trying to explain that will be a nightmare."
Beginning in January, most Americans will need to have health insurance and will be subject to tax penalties if they go without coverage. However, the penalties will not apply to low-income people denied access to Medicaid because they live in states that chose not to expand eligibility.
The Obama administration is advising people who "need health insurance" to report their telephone numbers and e-mail addresses to the government via a Web site,healthcare.gov, so they can be notified of new insurance options.
The history of Medicaid shows that it took several years for some states to sign up in the 1960s, raising the possibility that additional states may decide to expand eligibility in coming years.
Hannah Punitha (IRDA Licence Number: 2710062)
Robert Pear, May 2013
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