The ACA's language didn't account for the possibility that some states might not expand Medicaid, which is why the lower-end range of exchange plan subsidy eligibility starts off at 100% FPL...
Unfortunately, those earning less than 100% FPL are still stuck without any viable options besides either "going bare" and praying they don't get sick or injured or possibly buying a junk plan of some sort. According to the Kaiser Family Foundation, there's around 2.2 million Americans still caught in the "Medicaid Gap", where they don't qualify for Medicaid but don't earn enough to be eligible for subsidized ACA exchange policies (Kaiser estimates another 1.8 million uninsured adults in these states in the 100 - 138% "overlap" cateogory, plus around 356,000 who are eligible for Medicaid but still haven't enrolled for one reason or another).
Republican lawmakers blocked Medicaid expansion funding from reaching the Missouri House floor on Wednesday, posing a setback for the voter-approved plan to increase eligibility for the state health care program.
The House Budget Committee voted along party lines not to pass a bill allowing Missouri to spend $130 million of state funds and $1.6 billion in federal money to pay for the program’s expansion. Under the Affordable Care Act, the federal government picks up 90% of the tab on expanding Medicaid.
The expanded eligibility would allow estimated 230,000 additional low-income Missourians to be covered. It is set to go into effect in July after voters approved a ballot question last August with a 53% majority.
Missouri just voted #YesOn2 to expand Medicaid, and now, because of YOUR vote, over 230,000 hardworking people will have access to life-saving healthcare!pic.twitter.com/azHN0GJjEW
— YesOn2: Healthcare for Missouri (@YesOn2MO) August 5, 2020
Last summer, when activists in both Missouri and Oklahoma were preparing for this historic vote, I wrote the following:
During the early days of the Affordable Care Act (and again during the insane "Repeal/Replace" saga of 2017), one of the dumbest and most disingenuous talking points of Republicans was to attack the ACA for being "too long."
I'm quite serious...many Very Serious Conservatives stroked their beards and wrung their hands over the sheer length of the ACA's legislative text (officially around 2,700 pages, though if you includ the mountain of regulations which are included with any major bill impacting hundreds of millions of people it could theoretically be tracked at 20,000 pages or so).
In other words, only about 10% (at most) of those still in the Medicaid Gap could remotely match the GOP's cliche of a "lazy, good-for-nothing layabout" type who's able-bodied, has no serious extenuating circumstances and so forth. The "get off your ass and work!" requirements appear to be nearly as big a waste of time and resources as the infamous "drug testing for welfare recipients" bandwagon which a bunch of states jumped on board over the past few years.
“Get Covered America Day” — Dec. 10 — is a call to wear a mask to prevent the spread of COVID-19 and a public statement that you want your family and friends to get health insurance.
With COVID-19 cases surging nationally, the day is a call to action to encourage people to post a picture of themselves wearing a mask on social media, include a personal message about the importance of being COVID-safe and how friends, family and neighbors can get financial help for insurance now, sharing the website GetCovered2021.org and using the hashtag #GetCovered2021.
With an estimated 16 million uninsured Americans eligible for financial help — through their Affordable Care Act marketplace, or free coverage through Medicaid — Get Covered 2021 encourages people to check their health care options and get insured.
NATIONAL COALITION LAUNCHES “GET COVERED 2021” URGING AMERICA TO MASK UP AND GET INSURED – FOCUS ON COVID AND COVERAGE FOR 16 MILLION AMERICANS ELIGIBLE FOR FINANCIAL HELP NOW
“Get Covered” is a call to wear a mask to prevent the spread of COVID as well as a public statement that you want your family and friends to get health insurance.
COVID underscores why insurance matters - but not just because of the pandemic - coverage can help people stay healthy and provide a pathway to care for diseases like cancer, diabetes, and many others that impact people’s lives.
Get Covered 2021 will focus on getting the estimated 16 million uninsured people across America eligible for financial help – through their Affordable Care Act marketplace, or free coverage through Medicaid – insurance coverage now.
The Get Covered 2021 coalition announced that December 10th will be Get Covered America Day -- a day of action where everyone will be encouraged to keep wearing their mask and post a picture of themselves on social media, including a personal message about how friends, family and neighbors can get financial help for insurance now, sharing the website GetCovered2021.org and using the hashtag #GetCovered2021.
On Tuesday, August 4, all Missourians will have the chance to vote Yes On 2 to bring more than a billion of our tax dollars home from Washington every year – money that’s now going to places like California and New York instead.
By bringing our tax dollars home, we can protect thousands of frontline healthcare jobs, help keep rural hospitals open, and deliver healthcare to Missourians who earn less than $18,000 a year. That includes thousands of veterans and their families, those nearing retirement, working women who don’t have access to preventive care, and other hardworking Missourians whose jobs don’t provide health insurance.
Back in 2018, I was all over the trend of deep red states putting ACA Medicaid expansion on the ballot after getting fed up with years of their elected leaders refusing to do so. Idaho, Utah and Nebraska voters all did exactly that, passing it by solid margins. Unfortunately, state Republicans got in the way (or at least tried to) in all three states, adding hurdles, barriers and caveats which have either delayed or partly weakened them.
The big story with COVID-19 the past few weeks has been, of course, the out-of-control increase in new cases (if not actual deaths...yet) from the virus in red states like Texas, Florida and especially Arizona which were relatively unscathed throughout the spring while the pandemic was raging across Northeastern blue states like New York, New Jersey and Rhode Island, as well as Michigan and California.
While most of the states being hit with the summer wave are historically Republican strongholds (the states being hit hardest in June/July also include Georgia, Arkansas, South Carolina, etc.), there's one important exception to this: California, which was hit early but which clamped down fairly quickly, has re-emerged as a major hot spot. So what gives?
