Many citizens will find that they are not eligible for health cover - only because some states have opted not to expand their Medicaid program. Bruce Siegel, president and CEO of America's Essential Hospitals which is a group that oversees safety net institutions -said that by opting out of Medicaid expansion it defeated the purpose of the new health law.
"Originally the idea was that millions and millions of Americans would get health insurance," says Siegel, "They'd get coverage through Medicaid or through private insurance on the exchanges."
In many states only children, disabled people or pregnant women are eligible for Medicaid. According to the new health law citizens earning $15000 or less were eligible. The federal government is paying for the expansion of Medicaid for three years and only after that the states would pay 10%. Many states objected to this and in 2012 the Supreme Court left the decision to the state.
Siegel says. "They said states had the option of expanding their Medicaid program or not expanding it. And that led to a very, very different landscape than what we expected."
There are some 6-7 million people in the low income bracket who cannot get health insurance.
"Over 3 million of them live in just four states," says Genevieve Kenney, senior fellow and co-director of the Urban Institute's Health Policy Center. Those states are Florida, Texas, Georgia and North Carolina.
According to Kenney many of those who should be under Medicaid cannot buy private insurance as to do so their income needs to be $11000 a year individually.
"I think it's going to be confusing for individuals who are applying for coverage," says Kenney. "It certainly makes the message about the new affordable coverage that's available a lot more complicated to target."
In states which have agreed to expand the Medicaid program a lot more people will get health covers and in states with no intention to expand, many people will remain working, poor and uninsured. These people will have to turn community clinics and public hospitals for help. As a result free care costs will be higher in these states.
"Many of these hospitals will be overwhelmed," Siegel says. "Some of them are already overwhelmed; many of them are already losing money, providing a high level of service to people in need. And this will simply not be a tenable position."
Hannah Punitha (IRDA Licence Number: 2710062)
Julie Rovner, Oct 2013