Medicaid expansion: Kentucky 'Haves' and Indiana 'Have-Nots': The View from The Roasterie LIV: December 13, 2013
Behind the wave of "our red-state governors and legislatures are grinding the faces of our working poor in the dirt and bankrupting them by depriving them of their Medicaid" stories we are currently watching being written will be a wave of "our hospitals are falling apart and our doctors are falling behind blue-state ones because of our red-state governors and legislatures."
We will see whether that coming wave of stories will have any more effect than this one:
Laura Unger: Medicaid expansion: a case of the Kentucky 'haves' and the Indiana 'have-nots':
Because of the way the Affordable Care Act has played out, poor people on the Kentucky side of the Ohio River will have access to expanded Medicaid, but those on the Indiana side will not. In Kentucky:
- Residents earning less than 138 percent of the federal poverty level are eligible for expanded Medicaid. This means:
- An individual earning less than $15,856 a year would be eligible.
- A working mother with two children earning less than $26,951 a year would be eligible.
In Indiana:
- Jobless parents earning up to 18 percent of the federal poverty level, and working parents earning 24 percent of that level are eligible for traditional Medicaid, while adults without dependent children generally can’t get it.
This means:
- A working mother with two children earning up to $4,687 a year would be eligible.
- A jobless mother with two children earning up to $3,515 a year would be eligible....
Lorinda Fox of New Albany, Ind., hasn’t been to a doctor since her last child was born 21 years ago. Poor and uninsured, she treats her illnesses with over-the-counter remedies. At age 58, she knows she’s taking chances with her health, especially since she recently began having heart palpitations and chest pain. “I’ll do the same thing I always do--gut it out,” said Fox, who lives with her hearing-impaired daughter and earns about $12,000 a year working in retail. “I don’t know what else I can do.”
If Fox lived in Kentucky, she would qualify for expanded Medicaid next year under the Affordable Care Act. But she lives in a state where she makes too much to qualify for traditional Medicaid, and politicians have chosen not to expand Medicaid as Obamacare intended, contending that Indiana taxpayers can’t afford it....
It wasn’t supposed to work that way.... But the U.S. Supreme Court in 2012 let states choose whether to expand Medicaid, and as of Nov. 22, the Kaiser Family Foundation said only half, including Kentucky, had decided to do so. Indiana is among the 25 states that have decided against it, effectively creating a double whammy for some of the state’s poor residents: Not only do they miss out on gaining access to Medicaid, but they must pay full price for plans on the federal exchange. The ACA doesn’t offer health care subsidies to those earning less than the federal poverty level because the law presumes they would be covered by expanded Medicaid.... 181,930 Hoosiers will fall into this “coverage gap.”
