U.S. health care

By Tammy Alexander

The rocky rollout of the federal insurance exchange (and some state exchanges) was widely covered in the news media. However, the story of millions of uninsured who will fall through a large gap in coverage has been largely overlooked.

In 2012 the Supreme Court upheld most of the Affordable Care Act, but ruled that the federal government could not compel states to expand their Medicaid programs under the Act. Though the federal government will pick up 100 percent of the tab in 2014 (phasing down to 90 percent from 2016 to 2020 and beyond), only 23 states thus far have decided to expand their Medicaid programs.

As a result, more than 6 million individuals who fall below 138 percent of the federal poverty line will not receive Medicaid. Nor will they be able to receive subsidies to purchase insurance on the exchanges.

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