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.
Sandy 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
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
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.
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