The Medicaid expansion proposed under the Obama healthcare law is scheduled to take effect on January 1, 2014. According to the New England Journal of Medicine there are at least 22 state governors who are planning to implement the expansion as provided under the law. This includes four Republican governors, while another 13 Republican governors have stated staunch opposition to the expansion.
According to the article the differences in expanded Medicaid will create significant health care coverage gaps throughout the country. Low-income people in states that do not adopt the expansion will remain effectively without health care because their income does not allow for private insurance, while they still do not meet the eligibility criteria imposed by the state Medicaid programs.
Under the terms of the Medicaid expansion an estimated 16 million additional people will be covered under Medicaid should all states adopt it. These people were previously uninsured, but with some states choosing not to adopt the expansion it’s unclear how many of those uninsured people will remain without healthcare coverage.
The Medicaid expansion calls for allowing any individual or family earning below 133% of the federal poverty guidelines to apply for and receive Medicaid coverage. Current Medicaid eligibility criteria differ significantly from state to state.
An additional 15 governors have yet to decide whether they will expand Medicaid under the terms of the optional expansion, but the time to make that decision is running out. New budgets for the next fiscal year are due to be completed by July 1, meaning that more definite positions will be identified by then.