The New York Times would have you believe that the mean GOP governors who refused to expand Medicaid eligibility have prevented poor mothers from entering the Obamacare exchanges.
This is misleading. Many states already cover families up to 100 percent of the federal poverty line. If you are above that line but still poor, you can go into the exchanges and get a subsidy. It may not be affordable, but that is the fault of Obamacare, which over-promised and under-delivered.
If you are below the poverty line but in one of the states in which you are above the line (i.e. not eligible) for Medicaid, you can still go into the exchanges. But the Affordable Care Act made a decision not to give those people a subsidy. That is because such subsidization becomes frightfully expensive.
Now, if anyone is responsible for these people who fall through the cracks, it is Chief Justice John Roberts or Health and Human Services (HHS) Secretary Kathleen Sebelius. Roberts created an opt-out for states, giving them every incentive to opt out of Medicaid expansion. It is wise for many states to opt out because the federal government’s promise to pick up 90 percent the bill for a period of five years is written in invisible ink. At some point, states will be left holding the bag for the huge bill.
Sebelius is also responsible for this gap. HHS has routinely rejected requests for block granting from states. Governors think they could provide cheaper, better coverage with block grants. But the feds say no. In other words, a governor of a state that currently does not give Medicaid to a person at 90 percent of the poverty line very possibly could afford to do so if Sebelius would agree to a block grant.
That is what happened in Rhode Island. The state covers more residents and has stopped bleeding money. James Capretta of the Ethics and Public Policy Center says, “It’s working well. People are getting coverage.”
So, sorry New York Times. You can’t blame the governors for this one. Those people below poverty can enter the exchanges. If Obamacare wanted to give these people subsidies, it could. It tried to force states to do so, but Roberts let states choose. And if HHS would work with the states, the states could afford to cover these people. The problem with medical coverage for poor people is Medicaid, which is broken, fraud-ridden and inefficient. If the New York Times really wanted to shed light on the plight of those people, it would run a story on Rhode Island’s success and ask why Sebelius won’t help other states help the poor.