Back in 2010, when Obamacare was unfolding its propositions and plans for the implementation, a crucial aspect of the law was coverage to people below the federal poverty line, up to 138 percent of the federal poverty line through a proposed Medicaid expansion. However, in 2012, the proposal to expand Medicare coverage was shot down by Supreme Court. Twenty-four states are currently refusing  to align with the expansion (six of those are currently having an open debate on this issue but for the purpose of this post, I am counting them as a “not expand”), and have triggered a health law coverage gap for individuals who need subsidized health insurance coverage. The main, collective concern of these states was the financial liability that Medicaid expansion will add to the already struggling economy of the U.S.

Without the Medicaid expansion, people earning up to 138 percent of the federal poverty line are not eligible for any subsidies or discounted health insurance coverage. For a better look into the working of this demographic, let’s split the people in 0-100 percent of the poverty line and 100-138 percent of the poverty line. The motion to not to expand Medicaid is exceptionally hard on the people in 0-100 percent range. Without enough income to qualify for heavily subsidized plans, these individuals cannot buy health insurance, and in turn, will remain uncovered. The people in 100-138 percent demographic, on

As of now, this is the Sophie’s choice governors are facing across the nation – to allow Medicaid expansion and compromise on the insurance benefits for some while incurring huge financial burden across the nation, or to not allow Medicaid expansion and take away insurance from people below the federal poverty line to save the financial liability. In effect, they cannot benefit one group without hurting the other.

Stay tuned to see what the six states currently debating the issue will decide. And this story will continue as we see the repercussions for either decision – expand or not expand – bring to the market and to our economy.

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