Message #46109

[Psalm 51:17]

http://www.bloomberg.com/news/2014-01-06/obamacare-medicaid-split-creates-two-americas-for-poor.html?cmpid=yhoo
1/5/14
Obamacare Medicaid Split Creates Two Americas for Poor

Amber Sanchez, a San Francisco cancer survivor, skipped visiting the gynecologist last year to check a growth on her ovary because she was uninsured. This year, it’s at the top of her New Year’s plans.

The difference: As of Jan. 1, the 27-year-old is eligible for California’s Medicaid expansion under Obamacare.

In Alabama, which rejected the expansion, Jefferica Poindexter isn’t so lucky. Dealing with high cholesterol, chronic sinus pain and a bad back, she depends on emergency rooms and nonprofit clinics -- when they can see her.

“I’ve tried to go the clinic,” said Poindexter, who is 63. “They’re already booked by the time they get to me.”

The women’s fates are the consequence of a political debate that’s divided the U.S. roughly along party lines: Democratic-led states have expanded Medicaid programs for the poor under the health law; most Republicans have refused. While the law’s online exchanges draw more scrutiny, it’s Medicaid that may determine the health of millions of Americans. The expansion is one of the twin pillars created by the law to supply medical care to the nation’s uninsured, complementing subsidies for private insurance.

Still, with only 25 states choosing to participate in the expansion, almost 5 million people will be left out, according to the Kaiser Family Foundation, which studies health policy.

Real People

“These are real people with real health-care needs who may work but don’t have a lot of income, and no way to be able to afford health insurance,” said Kathleen Stoll, health policy director at Washington-based consumer group Families USA.

About 2.1 million people enrolled in private medical plans through the Patient Protection and Affordable Care Act last year, as its online insurance markets rebounded from software flaws that hobbled their debut in October. About 3.9 million more people were newly enrolled in Medicaid through November, according to a Dec. 20 report from the U.S. Department of Health and Human Services.

Medicaid sign-ups may have been higher if 25 states, mostly Republican-led ones in the south, hadn’t been able to opt out of the expansion. A 2012 Supreme Court decision upheld their right to refuse. The Obama administration is trying to persuade more Republicans to follow the lead of Arkansas and Iowa, which expanded Medicaid using private insurance plans, David Simas, a White House deputy senior adviser, said Jan. 2.

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