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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe Cruelty of Republican States in One Chart
Paul Waldman
The states rejecting the expansion of Medicaid are the ones that already make it the hardest for poor people to get insured.
Many people are talking today about this article in today's New York Times, which focuses on the particularly cruel doughnut hole created when the Supreme Court allowed states to opt out of the expansion of Medicaid in the Affordable Care Act. The problem is that if you live in a (mostly Southern) state run by Republicans, you have to be desperately poor to qualify for Medicaid under existing rules. But it isn't until you get to 133 percent of the poverty level ($31,321 in yearly income for a family of four) that you're eligible for subsidies to buy insurance on the exchanges, because when the law was written the idea was that everyone under that income would get Medicaid. When all those Southern states decided to refuse the Medicaid expansion in order to shake their fist at Barack Obama, they screwed over their own poor citizens. So millions of people will be caught in the middle: not poor enough to get Medicaid, but too poor to get subsidies on the exchanges. But when we say "not poor enough," what we're talking about is people who are, in fact, extremely poor. And you'll be shocked to learn that in those states, the poor are disproportionately black. Could that have anything to do with it? Heavens, no!
In any case, I thought it might be worthwhile to lay out in one handy chart how, state by state, this will affect people. Under pre-ACA law, each state sets its own eligibility level for Medicaid. In more liberal states, these levels are fairly high; for instance, Massachusetts gives Medicaid to families up to 133 percent of poverty, New York up to 150 percent, and Minnesota up to 215 percent. But in conservative states, the levels are far stingier; as someone in the Times article says, "You got to be almost dead before you can get Medicaid in Mississippi." In addition, in most states childless adults can't get Medicaid no matter how poor they are, but under the ACA it will no longer matter whether you have children. This is just one more way conservative states that forego the Medicaid expansion (for which the federal government is picking up almost the entire tab, by the way) are harming their own citizens...That means that the states where the Medicaid expansion would have done the most good for the most people are precisely those states where Republican governors and legislatures have told their poor citizens that they're out of luck.
When you look at these income eligibility levels, you see just how cruel the existing system is. For instance, in Alabama, you can't get Medicaid if your income exceeds 23 percent of the poverty level, or $4,500 for a family of three. Just think about that for a second. Do you think you could find a place to live, pay your bills, and feed your family on that income? But the state of Alabama says if you're that rich, you can afford to buy health insurance. In Texas, the state that will be depriving the most people of insurance by rejecting the expansion, only families under 25 percent of the poverty level, or $4,894 for a family of three, will be eligible for Medicaid. I'm guessing that's about what Rick Perry spends on boots every year.
- more -
http://prospect.org/article/cruelty-republican-states-one-chart
Medicaid expansion was to level the playing field in every state for every low-income American. See the charts in the following piece.
As enacted, the Affordable Care Act (ACA) would expand Medicaid to adults with incomes at or below 138% of the federal poverty level (FPL) ($15,856 for an individual as of 2013) starting January 1, 2014, nationwide.1 This expansion would significantly increase eligibility for parents in many states and end the historic exclusion of adults without dependent children, referred to as childless adults, from Medicaid. In addition, starting January 2014, the ACA establishes new streamlined eligibility and enrollment processes for Medicaid, which include determining income eligibility for most groups based on Modified Adjusted Gross Income (MAGI). The move to MAGI will largely align Medicaid income eligibility determinations with the standards used to determine eligibility for federal subsidies to help pay for coverage through the new Marketplaces.
While the Medicaid expansion was intended to occur nationwide, the Supreme Court ruling on the ACA effectively made it a state option. As of September 2013, 25 states, including DC are moving forward with the expansion and 26 states are not currently moving forward. There is no deadline for states to decide to expand. Regardless of state Medicaid expansion decisions, all states must implement the new eligibility and enrollment processes, including the transition to MAGI income determinations. As part of the transition to MAGI, states existing Medicaid income limits for children, pregnant women, parents, and childless adults will be converted to MAGI-equivalent limits.2 Tables 1 and 2 show Medicaid income limits for parents and childless adults as of January 2013, and the new income limits that will be in effect as of January 1, 2014.
In states that expand Medicaid, many low-income parents and other adults will become newly eligible for coverage. Overall, the median eligibility limit for parents in the 25 states moving forward with the Medicaid expansion will rise from 106% FPL to 138% FPL for parents and from 0% to 138% FPL for childless adults3 (Figure 1). However, the scope of changes for these groups varies widely across the states. Overall, eligibility levels will increase for parents in 18 states and for childless adults in 23 states. The remaining states in this group had already expanded Medicaid to higher incomes. These states will either maintain higher eligiblity levels or reduce eligibility to 138% FPL. In states reducing Medicaid eligibility, those losing Medicaid coverage would have incomes that would qualify for federal subsidies to help pay for Marketplace coverage.
In states that do not expand Medicaid, significant coverage gaps will remain for many poor adults. In the 26 states not currently moving forward with the Medicaid expansion, adults between the January 2014 Medicaid eligibility limits and 100% FPL will not gain a coverage option. These adults will not be eligible for Medicaid or the federal subsidies to help pay for Marketplace coverage. As of January 2014, 22 states will have Medicaid eligibility levels for parents below 100% FPL (Figure 2). Childless adults in these states will generally remain ineligible for Medicaid coverage regardless of how low their income levels are.4
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http://kaiserfamilyfoundation.files.wordpress.com/2013/10/8497-medicaid-eligibility-for-adults-as-of-jan-1-20144.pdf
List of states and Governors who refused to expand Medicaid (updated)
http://www.democraticunderground.com/10023789546
cali
(114,904 posts)calimary
(81,500 posts)We've got a bunch of 'em in statehouses around the country. Anywhere there's a teabag that isn't in hot water where it belongs, you see it.
And I say this as a confirmed tea drinker. I've been a hot tea lover since I was old enough to hold a cup by myself. Started with the plain ol' Lipton and soon expanded to Celestial Seasonings and beyond! Only got into coffee much later.
I also hate the way these schmucks are giving tea a bad name.
dgibby
(9,474 posts)Just posted this to my FB page for my Tea Party "friends" to see.
just how unevenly Medicaid was being applied and the cruelty of rejecting the expansion.
About half of the 17 million Americans eligible for Medicaid will gain coverage in the states that accepted the expansion, but the other half will suffer because Republicans hate the law.
Egalitarian Thug
(12,448 posts)Ron Green
(9,823 posts)I make Oregon's eligibility for a family of 3 to be $19,536.
ProSense
(116,464 posts)Pretzel_Warrior
(8,361 posts)because it looks like Medicaid eligibility levels are independent of whether a state is red or blue or accepted Medicaid expansion or not.
ProSense
(116,464 posts)"I agree that the post and chart make it confusing because it looks like Medicaid eligibility levels are independent of whether a state is red or blue or accepted Medicaid expansion or not."
...the blue bar indicates that the state accepted the expansion for 2014, the red means it did not.
Here is Alabama's eligiblity for a family of three in 2013:
Medicaid Income Limits for 2013
02/2013):
Income after deductions cannot exceed $958 per month for a family of 1
Income after deductions cannot exceed $1,293 per month for a family of 2
Income after deductions cannot exceed $1,628 per month for a family of 3
Income after deductions cannot exceed $1,963 per month for a family of 4
Medicaid for Low Income Families:
Income after deductions cannot exceed $111 per month for a family of 1
Income after deductions cannot exceed $137 per month for a family of 2
Income after deductions cannot exceed $164 per month for a family of 3
Income after deductions cannot exceed $194 per month for a family of 4
http://medicaid.alabama.gov/documents/3.0_Apply/3.2_Qualifying_Medicaid/3.2_Medicaid_Income_Limits_2013_2-1-13.pdf
If you look at the table on page 3 at the link below, you will see the states that accepted the expansion have the same eligibility level in 2014 for family of three ($26,951) and for other adults ($15,856)
Table 2: Medicaid Income Eligibility Limits for Adults Based on Annual Income January 2013 and January 2014
Parents of Dependent Children (in a family of three)
http://kaiserfamilyfoundation.files.wordpress.com/2013/10/8497-medicaid-eligibility-for-adults-as-of-jan-1-2014.pdf
Alabama is listed under "NOT MOVING FORWARD WITH THE MEDICAID EXPANSION AT THIS TIME "
Jobless $2,013
Working $4,493
2014 $3,221
Adults 2014 do not qualify
seveneyes
(4,631 posts)bunnies
(15,859 posts)compared to how horrible the state I live in treats ours. I had no idea the differences were so immense.
ProSense
(116,464 posts)bunnies
(15,859 posts)Sick bastards.
Doctor_J
(36,392 posts)Life in the United states would be like heaven if the red states were cut loose.
kentauros
(29,414 posts)treestar
(82,383 posts)Than some states were after.
ProSense
(116,464 posts)mia
(8,362 posts)The chart says it all.
ProSense
(116,464 posts)There is no excuse for turning down the expansion.
JaneyVee
(19,877 posts)Likewise, bottom 10 some of the unhealthiest.
ProSense
(116,464 posts)Democratic Governor.
gulliver
(13,195 posts)Pointing out that they are being cruel only makes them feel good. They are so stupid that they are willing to give billions of their own money to other states. Millions of good doctor, nurse, and medical administrative jobs are being shoveled out of red states because of their Republican leaders. The poor will still go to their emergency rooms and their bills will go to the red state medical care consumers. Everyone loses.
ProSense
(116,464 posts)they're terrorists.
Scuba
(53,475 posts)ProSense
(116,464 posts)ProSense
(116,464 posts)ProSense
(116,464 posts)http://www.democraticunderground.com/10023816659
Response to ProSense (Original post)
DireStrike This message was self-deleted by its author.
MSMITH33156
(879 posts)at some point, there will be a reprieve and they will have the option to accept the medicaid expansion again. People in those states are going to realize they got screwed, and they will be given a do over.
ProSense
(116,464 posts)By Scott Keyes
Hope isnt an insurance policy.
This is the lesson that Paul, a 55-year-old San Francisco man with thin, wispy hair reminiscent of a benevolent mad scientist, learned three years ago when his closest friend died from cancer. She was diagnosed in early 2010. Four months later, lacking insurance and any means to pay for care, she died.
<...>
Things werent always bad for Paul, who preferred not to divulge his last name or have his photo taken. He had worked for a big technology company for years. When layoffs came following the dot-com bubble, he took a buyout and used the money to start his own IT consulting business. It was thriving, he explained. That is, until demand dried up after the 2008 market crash. His business went under and he was soon evicted...He has been homeless for nearly five years, sleeping in his car and trying every day to find work. Its been 12 years since he had health insurance. For Paul, health care has meant aspiring, an annual flu shot, and confidence he wont get sick.
<...>
On Monday, Paul showed up at Project Homeless Connect, a services fair for homeless people held near the Castro district of San Francisco, unsure of what hed find...The problem is that, even though he had no health care, no home, and no assets, he still wasnt eligible for Californias Medicaid program, Medi-Cal. Thats because for years, only people who were elderly, disabled, or had dependent children were eligible for Medi-Cal. Childless adults like Paul were excluded from the system.
That is, until Obamacare.
One of the most important reforms in the Affordable Care Act is the expansion of Medicaid to cover anyone with an income at or below 133 percent of the federal poverty level...I ran into Paul after his consultation with SF PATH, a federally-funded insurance program that has served low-income San Franciscans, but will automatically roll over all its enrollees into Medi-Cal beginning on January 1, 2014.
- more -
http://thinkprogress.org/health/2013/10/11/2761931/homeless-obamacare/
BumRushDaShow
(129,513 posts)it shows PA "accepted Medicaid Expansion" where Corbett didn't really accept the base program. He put together his own phony rethug "plan" with recommendations on how to modify the base program (e.g., including "work search" requirements, etc), but it has to be approved by HHS first.
I saw a story last week where a TN "alternative" expansion plan had just been approved by HHS and Corbett was looking to that as a sign that maybe his plan might get approved too... But there's no word yet.
ProSense
(116,464 posts)yes, the plan still has to be approved. The situation is still fluid.
In Ohio, Kasich now wants to accept the expansion.
BumRushDaShow
(129,513 posts)Instead, Corbett has chosen a needlessly complicated and potentially more expensive approach that would send federal Medicaid dollars to private insurance carriers, while also adding unnecessary, and likely illegal, hurdles for Pennsylvanians to get coverage.
Even if Corbett receives federal approval, which is by no means guaranteed, it will likely take months of negotiations. That means that those 500,000-plus Pennsylvanians, who need health care coverage, will have to wait while their neighbors in other states start getting covered as of Jan. 1, 2014, using Pennsylvanians federal tax dollars.
<..>
They need health care coverage for themselves and their families. They cannot afford to wait.
http://www.keystonepolitics.com/2013/10/guest-column-gov-corbett-should-accept-real-medicaid-expansion/
ProSense
(116,464 posts)Jefferson23
(30,099 posts)does not hate people.
This also needs to be the blueprint to change the red states blue, 2014. Appeal
to what is a basic core need, one's health.
ProSense
(116,464 posts)whttevrr
(2,345 posts)The creator of that chart is using monthly amounts at the top and annual amounts at the bottom.
whttevrr
(2,345 posts)ProSense
(116,464 posts)in states that haven't expanded Medicaid.
Arizona and Arkansas accepted the expansion. Florida did not.
whttevrr
(2,345 posts)ProSense
(116,464 posts)Children are covered under CHIP. That doesn't mean a parent is eligible for Medicaid.
ProSense
(116,464 posts)whttevrr
(2,345 posts)Arkansas annual madicaid eligibility requirement as of Jan 1 2014 is $41,208
I ended up self deleting my post when I figured out that the chart I posted, which is the same exact chart posted here, was wrong.
It is a totally made up fake chart that you cannot find anywhere but here: http://economistsview.typepad.com/economistsview/2013/10/medicaid-eligibility-by-red-blue-state.html
ProSense
(116,464 posts)whttevrr
(2,345 posts)You should self delete. It is a fake chart that compares monthly to annual requirements.
ProSense
(116,464 posts)http://kff.org/medicaid/state-indicator/income-eligibility-low-income-adults/
Parents of dependent children qualify for Medicaid in Alabama at 23 percent of FPL.
Children are covered under SCHIP.
seveneyes
(4,631 posts)Link to all charts here...
http://www.medicaid.gov/AffordableCareAct/Medicaid-Moving-Forward-2014/Medicaid-and-CHIP-Eligibility-Levels/medicaid-chip-eligibility-levels.html
I can't see why anyone would want to mix monthly and annual incomes on a chart.
ProSense
(116,464 posts)by elibility as a percentage of FPL in 2013
http://kff.org/medicaid/state-indicator/income-eligibility-low-income-adults/
Note that in Alabama, parents qualify at only 23 percent of FPL. Childless adults do not qualify.
The chart you linked to is effective January 2014.
Childless adults still don't qualify for Medicaid in Alabama.
whttevrr
(2,345 posts)Your chart that you posted is for a family of three. It also, by your just now posted data, proves that it is monthly amounts on the top and annual amounts on the bottom. It is wrong in several different ways. Your link actually proves the falsity of the chart in the OP.
ProSense
(116,464 posts)02/2013):
Income after deductions cannot exceed $958 per month for a family of 1
Income after deductions cannot exceed $1,293 per month for a family of 2
Income after deductions cannot exceed $1,628 per month for a family of 3
Income after deductions cannot exceed $1,963 per month for a family of 4
Medicaid for Low Income Families:
Income after deductions cannot exceed $111 per month for a family of 1
Income after deductions cannot exceed $137 per month for a family of 2
Income after deductions cannot exceed $164 per month for a family of 3
Income after deductions cannot exceed $194 per month for a family of 4
http://medicaid.alabama.gov/documents/3.0_Apply/3.2_Qualifying_Medicaid/3.2_Medicaid_Income_Limits_2013_2-1-13.pdf
ProSense
(116,464 posts)Table 2: Medicaid Income Eligibility Limits for Adults Based on Annual Income January 2013 and January 2014
Parents of Dependent Children (in a family of three)
NOT MOVING FORWARD WITH THE MEDICAID EXPANSION AT THIS TIME
Alabama
Jobless $2,013
Working $4,493
2014 $3,221
Adults 2014 do not qualify
whttevrr
(2,345 posts)ProSense
(116,464 posts)You refuse to face facts.
Laelth
(32,017 posts)Anybody have a reasonable explanation for that?
-Laelth
ProSense
(116,464 posts)...you should be reading The Incidental Economist on the Oregon Medicaid study thats creating a lot of fuss today. Basically, budget woes forced Oregon to allocate Medicaid access by lottery, giving a rare randomized experiment. Those who got Medicaid suffered much less financial distress and less depression; they received more preventive care; but on some (not all dimensions) their health wasnt significantly better than those who lost out in the lottery.
Somehow, conservatives think this is a big win for their opposition to universal health insurance. Why? What it suggests is that the health benefits of ANY kind of health insurance are somewhat hard to identify over a two year period; so, are you about to give up your own insurance, or is your best bet that having that insurance is still a very good idea? And the financial benefits are a big part of that! Since you are going to treat your illnesses, better not to bankrupt yourself in the process, right?
Oh, and until now the claim of right-wingers has been that Medicaid actually makes you sicker; serious researchers have always said that this was a case of selection bias, because sicker people got Medicaid and now we have confirmation: those who got Medicaid were at least somewhat healthier than those who didnt.
Above all, you should bear in mind that if health insurance is a good idea and you are nuts if you let this study persuade you otherwise Medicaid is cheaper than private insurance. So where is the downside?
http://krugman.blogs.nytimes.com/2013/05/02/medicaid-nonsense/
http://www.democraticunderground.com/10022787503
Laelth
(32,017 posts)-Laelth
ProSense
(116,464 posts)LukeFL
(594 posts)ProSense
(116,464 posts)As part of its state-by-state effort to dismantle the Affordable Care Act, a group backed by billionaire conservative benefactors Charles and David Koch is going after a Republican lawmaker in Virginia who has signaled an openness to the law's Medicaid expansion.
An article published Saturday in The New York Times details how the conservative advocacy group Americans for Prosperity is employing a grassroots campaign to pressure state lawmakers to reject the Medicaid expansion under the health care law.
The group is currently going all out in Virginia, where this year's gubernatorial race pits a Democrat who favors expansion (Terry McAuliffe) against a Republican who opposes (Ken Cuccinelli). It's also targeting Republican state Sen. Emmett W. Hanger Jr., who is considering signing off on the expansion.
This has been one of those trench warfare kind of efforts for a year now, and I think it is one of those hidden stories of the whole fight against Obamacare, Tim Phillips, president of Americans for Prosperity, told the Times. Its not flashy; its just in a whole bunch of state capitals and in the districts of a whole lot of state legislators, but its such a crucial aspect of the overall long-term effort to roll back Obamacare.
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http://talkingpointsmemo.com/livewire/koch-backed-group-wages-trench-warfare-against-obamacare-medicaid-expansion
ProSense
(116,464 posts)By Tara Culp-Ressler
On Monday, Ohio became the fourth GOP-led state to agree to expand Medicaid under Obamacare. Gov. John Kasich (R) has been pressuring his fellow Republicans to expand the public program for months, and finally secured the necessary support with a 5-2 vote from a special panel of seven lawmakers.
That decision isnt sitting well with some conservatives in the state, however. Two anti-abortion groups and six Republican lawmakers filed a lawsuit on Tuesday to prevent the state from accepting the federal money intended to fund the Medicaid expansion. They contend that it was illegal to go around the legislature to approve the move through a special committee.
The Associated Press reports that the Right to Life chapters in Cleveland and Cincinnati are joining the lawsuit because they oppose the use of federal funding for expansion and wanted the chance to debate the issue with the Legislature, according to the filing.
Its unclear why thats a priority for the anti-choice groups. Some abortion opponents have taken issue with the health reform law because they believe it expands access to taxpayer-funded abortion services, but thats a misrepresentation. Obamacare doesnt designate any federal funding for abortion coverage and federal Medicaid dollars are already banned from covering abortion under the Hyde Amendment.
- more -
http://thinkprogress.org/health/2013/10/23/2822291/pro-life-groups-medicaid-ohio/
http://www.democraticunderground.com/10023906739
Scurrilous
(38,687 posts)Liberal_in_LA
(44,397 posts)ProSense
(116,464 posts)This shouldn't sink.