Unlucky Duckies

HHS regulations just issued clarifying implementation of the individual health care purchasing mandate should draw attention to the human costs associated with the little temper tantrums certain governors are throwing.

The regs quite logically exempt from the mandate people who would have become eligible for Medicaid under the expansion authorized by the Affordable Care Act. What this dramatizes is the “coverage hole” affecting adults in families with incomes below the federal poverty line in the 33 states where they do not already qualify for Medicaid coverage. At income levels between 100% and 133% of the poverty line, these people will be eligible for coverage under the new health care exchanges. But below the poverty line? They’re out of luck if their states don’t already cover them and now reject the Medicaid expansion.

By my rough back-of-the-envelope calculation from Kaiser Family Foundation numbers, there are about 4 million of such unlucky duckies in the 10 states that are pretty clearly not going to participate in the Medicaid expansion, a number that could jump to well over 5 million if Rick Scott manages to keep Florida out as well. The pols involved, of course, would deny exchange coverage to those with incomes between 100% and 133% of the poverty line if they had the power to do so. So what do they care about the injustice of this coverage hole?

Not a thing, clearly.

Ed Kilgore

Ed Kilgore, a Monthly contributing editor, is a columnist for the Daily Intelligencer, New York magazine’s politics blog, and the managing editor for the Democratic Strategist.