Study: No Medicaid Expansion Means No New Options for Low-Income Uninsured

As many as 42 percent of people who were uninsured at any point from 2010 to 2012 could not have access to new coverage options under the Patient Protection and Affordable Care Act in states that haven't decided to expand Medicaid, according to a report from The Commonwealth Fund.

From 2010 to 2012, 32 percent of adults aged 19 to 64 in the U.S. were uninsured either continuously or for some period of time during those two years, according to the report. Furthermore, 68 percent of adults in households with incomes below 133 percent of the poverty level for all or part of that interval were uninsured for all or part of that two-year period. 

As of August 2013, 21 states and the District of Columbia have opted to expand their Medicaid programs. Of the remaining states, three are carrying out an expansion with some variation on what's laid out in the reform law, five are unclear or undecided and 21 have said they won't extend the program, according to the report.

Adults with incomes below 100 percent of the federal poverty level also won't be eligible for tax subsidies to help them pay for coverage purchased through the new health insurance exchanges. As a result, in states that don't expand Medicaid, many of the poorest adults still won't have access to affordable coverage under the PPACA, according to the report.

Federal officials and policy experts have urged states to expand their Medicaid programs. HHS Secretary Kathleen Sebelius has advocated for expansion, saying she's eager to work with policymakers looking to expand Medicaid in innovative ways.

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