ACA Medicaid Expansion—Why did some States Opt-Out?


ObamaCare Medicaid Expansion was one of the biggest milestones in health care reform. ObamaCare’s Medicaid expansion expanded Medicaid to our nations poorest in order cover nearly half of uninsured Americans. The law previously required states to cover their poorest or lose federal funding to Medicaid (federal funding covers 90-100% of state costs) until the supreme court ruling on ObamaCare.  After the ruling, states could opt-out of the ACA Medicaid Expansion, and as Republican-led states did, it left millions of poor working families without coverage.

Under the ACA (Affordable Care Act, e.g., Obamacare), a new national Medicaid income eligibility level was established at 138% of the Federal Poverty Line.  (That 138% amount is about $15,400/year for an individual; $32,000/year for a family of 4.)  States that opted out of the ACA Medicaid expansion are projected to drive up insurance costs drastically in their states, potentially drive hospitals out of business, and save relatively little, if anything at all.

The ACA Medicaid expansion attempted to bring some uniformity across the nation to how Medicaid is administered.  Prior to 2013, every State had different eligibility requirements based on income, age, gender, dependents, and other state-specific requirements.  Starting in 2014, all states that expanded Medicaid have uniform eligibility requirements.  Those that did not, still have their previous requirements, and left millions of poverty-ridden people without effective healthcare options.

Read more about the ACA Medicaid Expansion here.

On a side note:

Today in the House of Representatives,219 Republicans voted to pass Rep. Paul Ryan’s “Path to Poverty” budget that would REPEAL the Affordable Care Act and turn Medicaid into a block grant to States.  Please note that a “block grant” is a large sum of money granted by the US Government to various State Governments, with only general provisions as to the way that money is to be spent.  It’s very easy to re-task that money into a slush fund with which to pay for other pet and ideological projects at the expense of those in desperate need.

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