Politics Leaves Millions Uninsured & Ineligible for Affordable Care Act Benefits

Adding insult to injury, political posturing not only hurts those that the Affordable Care Act was intended to help the most, but also makes them subject to fines.

States and the Medicaid Expansion

By Chris Hoenig

Politics Leaves Millions Uninsured & Ineligible for Affordable Care Act Benefits

States and the Medicaid Expansion

Insurance exchanges set up by the Affordable Care Act are open, and Blacks and Latinos are expected to make up the majority of new enrollees in the healthcare marketplace. But governors in nearly half the states in the country have been able to exclude their residents from parts of the law, leaving millions—mainly low-income Blacks and single mothers—with no way to find health coverage.

And as if that wasn’t hard enough, many of them will face fines because of the healthcare law.

As part of the Affordable Care Act, all Americans are required to have health insurance or face fines. To do that, subsidies are made available for middle- and low-income individuals and families. For those with the lowest incomes, an expansion of Medicaid provides coverage. The federal government covers the full cost of the expansion through 2016 and no less than 90 percent of the cost after that. The program is designed to insure about 14 million Americans who are eligible, uninsured and living in poverty.

But as part of the Supreme Court decision that upheld the law, states were given the ability to opt out of the Medicaid expansion. In all, 26 states—nearly every one with a Republican governor—have opted not to take part in the expansion. While home to only about half of the country’s population, these 26 states, largely located in the South and Midwest, are home to 60 percent of the country’s working poor and about 68 percent of the low-income, uninsured Blacks and single mothers that the Medicaid expansion was meant to help cover.

That leaves about 8 million Americans who make too little to qualify for subsidies to offset the cost of private insurance, but make too much to qualify for Medicaid under the current guidelines.

In Mississippi, 56 percent of all poor and uninsured adults are Black, even though Blacks make up only 38 percent of the state’s total population. Home to the largest percentage of poor and uninsured people in the country, Mississippi residents can have a maximum income of about $3,000 per year to qualify for Medicaid without the expansion.

“You got to be almost dead before you can get Medicaid in Mississippi,” Willie Charles Carter told The New York Times. Unable to qualify for insurance because Mississippi is one of the states that rejected the Medicaid expansion, Carter is also faced with the closing of his local clinic next month due to lack of funding. “I’m scared all the time,” he said. “I just walk around here with faith in God to take care of me.”

Carter’s income is below the Medicaid threshold, but because he has no children, he doesn’t qualify without an expansion of the program. “If you look at the history of Mississippi, politicians have used race to oppose minimum wage, Head Start, all these social programs,” Dr. Aaron Shirley, a physician in Mississippi, said. “It’s a tactic that appeals to people who would rather suffer themselves than see a Black person benefit.”

And to make the suffering worse for these still-uninsured Americans, they will be subject to fines under the Affordable Care Act for not having insurance.

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  • Catherine Kutka

    This situation is shameful! I experienced this type of problem myself when I was a young single parent. I can’t believe that 20 years later this is not only tolerated but proliferated by our elected representatives!! The politicians who opt out of ACA should have been required to live the life of one of their constituents before being allowed to make this choice that affects the lives of so many others. I am utterly disgusted that our society continues to reflect that of the Middle Ages – the haves and the have-nots. So much for enlightenment…

  • Paul G. Patton

    The only “problem” we have is that nefarious group of people whose rallying call is get that Black Man out of our White House. I love this country Luke as evidenced by my 27 years wearing the cloth of our nation. There is no other place I solidly choose to live because warts and all, this is still my country. That said, we need to recognize that we are not the strongest country on earth by divine right. I have feared for years that racism and greed would be the downfall of our nation. As a Father of 2 and the Grandfather of 3 I am heavily invested in our country and I pray a lot. GOD bless you for all you do and feel free to use my comments anyway you wish.


  • This country need to clean house starting w/ all elected officials in both houses of Congress. Republican or Democrat, doesn’t matter, the fact that any party that is so strong, & holds sway over 1/2 the states, effectively shutting off their OWN PEOPLE from heatlh insurance, shows what we all know, our system of government has huge holes in it and we need more fair & objective checks & balances.

    Consdiering how recent our country was founded, we have come a long way, blazing our way to the top, taking down the Soviet Empire and securing our spot as the #1 superpower.our technology is amazing, our people are all so amazing, but our leaders are garbage. This story proves it. These fossils from a bygone era our holding this entire nation from realizing its fullest potential… and why? Outdated, subjective beliefs. Not objective fairness for all people, period. They are allowed to have those beliefs of course, but they should NOT rule with them

    I’m 34, born & raised here, & love this country. I’m excited for all our yet to be untapped potential, but I’m silently worried for our long term relevance. Worst case scenario if something happens we will all pull together as always & stake our claim again, but we need to start in house.

    It is so simple….. why’t can’t we rule & govern ourselves based on only 1 standard. That of a human being. Any other label you attach after that is irrelevant. Human law,, & health care, for all our human citizens. Period.This article is embarrsing. We’ve come so far, but are poisoning ourselves from the inside out. These leaders are a tiny, tiny majority of over 350 million people… when we will we all stand & shout what we all silently know & agree upon? Take care of our own first, focus internally, work together and eject these parasites on capitol hill who sit & play with people’s lives like it was a board game. Give everyone health care, and take theirs away.


  • It seems to me the House of Representatives represent themselves. They are out of touch with what the American people want. The Speaker has a FaceBook page that I moniter. More than half the comments are against his actions. Yet he bends to the Tea Party demands, which is minority rule. This country is based on Majority rule, and the poor minorities suffer. Here we have an instance where the minority is ruling (tea party) and the poor are still suffering. We are a mess.

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