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5 million fall into Obamacare coverage gap

Most in states that didn’t expand Medicaid

- The Washington Times - Tuesday, December 17, 2013

The Kaiser Family Foundation said Tuesday that roughly 5 million Americans will earn too much money to qualify for a government health-insurance program and too little to qualify for subsidized coverage under Obamacare next year.

These Americans are in this "coverage gap" because they live in states that opted not to expand Medicaid under President Obama's overhaul.

The nonpartisan organization said the people that fall into this coverage gap are concentrated in states with the largest uninsured populations. 

More than a fifth of them live in Texas, 16 percent live in Florida, 8 percent in Georgia, 7 percent in North Carolina and six percent in Pennsylvania, according to Kaiser's policy brief.

Under the Affordable Care Act, states may expand their Medicaid programs to those making up to 138 percent of the federal poverty level. The reform was supposed to take place nationwide, but the Supreme Court made it optional in its landmark 2012 ruling on Obamacare.

The federal government is supposed to pay for 100 percent of the expanded population in 2014-2016 before scaling back its contribution to 90 percent by 2020.

About half the states decided not to expand the federal-state entitlement. This left a gap in financial assistance under Obamacare, because the law only provides subsidies for private coverage to those making between 100 percent and 400 percent of federal poverty.

Wisconsin avoided the coverage gap, because it is offering Medicaid to adults up to the poverty level in 2014, Kaiser noted.

Kaiser said many of the people who fall into the coverage gap reside in the South.

It is difficult for people in these areas to qualify for Medicaid, it said, with the median income limit for parents in 2014 resting at 47 percent of the federal poverty limit, or about $9,200 a year for a family of three. 

Nearly all the states that are not expanding Medicaid have decided to keep childless adults ineligible for the program, Kaiser said.

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