They also estimate that another 1.8 million uninsured Americans who are eligible for subsidized ACA exchange plans who would be eligible for Medicaid instead if those state actually did expand Medicaid (and perhaps another 100K in Missouri). That's nearly 4.0 million total...
So, how to crack this nut in these holdout states, all of which are either completely or partially controlled by Republicans who have adamantly refused to expand the program no matter what all these years?
As I (and others) have written many times, closing the so-called "Medicaid Gap" is one of the trickiest challenges President Biden and Congressional Democrats face when it comes to strengthening and improving the Affordable Care Act.
Once again: Under the ACA, all Americans earning up to 138% of the Federal Poverty Level (FPL)... roughly $17,700/year for a single adult or around $36,500 for a family of four...were supposed to be eligible to join Medicaid regardless of their health status, whether they had kids and so forth.
This was supposed to be the case in all 50 states and the District of Columbia (I'm not sure about Puerto Rico or the other U.S. territories...many ACA provisions never applied to them in the first place).
Unfortunately, one of the major consequences of the NFIB vs. Sebelius Supreme Court Case in 2012 was that expansion of the Medicaid program has to be voluntary on the part of each state.
About a year and a half ago, U.S. Senator Tammy Baldwin (D-WI) introduced a bill which would cut down on ACA premiums considerably for younger enrollees by beefing up the subsidy formula for the so-called "Young Invincible" population: Adults between 18 - 34 years old. Last week, she re-introduced the bill along with U.S. Representative Don McEachin (D-VA).
While the bill, titled the "Advancing Youth Enrollment Act", wouldn't have nearly as much impact on premiums or enrollment as the more expansive ACA 2.0 bills I've been promoting (H.R. 1868 & 1884 in the House; S.1213 in the Senate), anything which reduces premiums for more people without reducing patient protections or coverage standards is always a good thing in my book, so I'm happy to give Baldwin's bill another shout-out:
The Advancing Youth Enrollment Act lowers health care costs while maintaining critical ACA protections
Senate Democrats are preparing a long-shot procedural maneuver to reverse new Trump administration regulations that they say would sabotage the Affordable Care Act by expanding “junk” insurance that isn’t obligated to cover preexisting conditions.
Wisconsin Senator Tammy Baldwin has been on a bit of an "Improve the ACA" tear lately. A couple of weeks ago she introduced the "Fair Care Act" to try and nip Donald Trump's #ShortAssPlans proposal in the bud. Now she's introduced another bill which would help shore up the ACA exchanges themselves: The "Advancing Youth Enrollment Act" via Kimberly Leonard of the Washington Examiner):
The Advancing Youth Enrollment Act would give higher federal subsidies to people between the ages of 18-34 so that the cost of private Obamacare plans for them would be lower.
...Under the proposal, young adults would see the maximum percentage of income they must pay toward health insurance under Obamacare decrease by 2.5 percentage points for people between the ages of 18 to 30. Each year after, until the age of 34, they would see a gradual phaseout of 0.5 percentage points a year.
U.S. SENATOR TAMMY BALDWIN AIMS TO BLOCK PRESIDENT TRUMP’S PLAN TO ALLOW INSURERS TO SELL JUNK PLANS WITH LEGISLATION TO GUARANTEE PROTECTIONS FOR PRE-EXISTING CONDITIONS
“The Fair Care Act is an opportunity for lawmakers to keep their word on guaranteed protections for pre-existing conditions.”
WASHINGTON, D.C. – Following the Trump Administration’s recent proposed rule allowing insurance companies to once again sell ‘junk’ health care plans, U.S. Senator Tammy Baldwin today announced new legislation to block the rule and guarantee protections for people with pre-existing conditions.