Why 4M Americans don't have access to health insurance post-PPACA


The Patient Protection and Affordable Care Act originally required states to expand their Medicaid programs to cover those earning as much as 138 percent of the federal poverty level, or $27,310 for a family of three. However, a 2012 U.S. Supreme Court decision made Medicaid expansion optional, which has left millions of Americans without access to health coverage, according to a recent Kaiser Family Foundation report.

This year, the median income limit for parents to qualify for Medicaid in states that have not expanded the program is $9,893 for a family of three, and adults without children do not qualify for Medicaid in nearly all non-expansion states.

Since Medicaid was originally required to be expanded in all states under the PPACA, the health reform law didn't provide financial assistance for those who fall below the federal poverty level. Therefore, there is a group of 4 million people across the nation who fall into a coverage gap, meaning they make too little to qualify for financial assistance under the PPACA, but they make too much to qualify for Medicaid, according to the report.

Since 2013, the number of people falling in the coverage gap has decreased by about 600,000, due to Ohio, New Hampshire and Pennsylvania expanding their Medicaid programs.

The vast majority (86 percent) of those who fall into a coverage gap reside in the south, with 11 of the 23 states not expanding Medicaid located in that region. Twenty-five percent of the people who fall into a coverage gap reside in Texas, which is the greatest percentage of any state, according to the report. 

With their states forgoing expansion, it is unlikely those who fall into a coverage gap will be able to afford insurance without financial assistance. This year, the average price of a bronze plan on the marketplace was roughly $224 per month, which is equal to about half of the monthly income of those who fall into the lower income range of people in the coverage gap.

More articles on Medicaid expansion:

Election results make Medicaid expansion unlikely in 5 states 
Will North Carolina be the next state to expand Medicaid? 
Will Medicaid expansion hurt Indiana's economy? 

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