GOP Governors Lock Poorest Americans out of Obamacare

By Tara Culp-Ressler, ThinkProgress

15 May 14

espite the fact that Affordable Care Act has been in place for four years by now, more than one million low-income Americans who are dependent on community health centers are still going uninsured, according to a new report conducted by researchers at George Washington University.

Patients at community health centers, which receive federal funding to operate in medically underserved communities, are typically even poorer than the uninsured population as a whole. They also tend to be in worse health compared to other low-income people. Nonetheless, many of these vulnerable Americans are locked out of health reform because they live in states that have rejected Obamacare’s optional Medicaid expansion:

According to the researchers, more than 70 percent of those people live in just 11 southern states. And 35 percent of them live within the borders of five states: Alabama, Florida, Georgia, Louisiana and Mississippi. The southern region of the United States has historically struggled with higher rates of uninsurance, poverty, and preventable health issues. Nonetheless, GOP lawmakers there continue to resist cooperating with health reform at any cost.

“These low-income patients, many of them living in the South, already face significant challenges to obtaining health care,” Dr. Peter Shin, the lead author of the study and the director of the Geiger Gibson Program in Community Health Policy, explained. “Our analysis suggests these patients will remain without access to affordable insurance, which will almost certainly lead to delays in care and the risk of more serious health conditions.”

And in addition to the human cost, there are also serious financial consequences to resisting Medicaid expansion. Community health centers make a lot more money from Medicaid reimbursements than they do from the sliding scale of payments they receive from the uninsured. The new report estimates that community health centers in anti-expansion states will forgo $569 million in the revenues they would have collected from new Medicaid patients. Rural hospitals in those states are also being forced to close, since there aren’t enough patients with insurance to ensure they have enough funding to remain operating.

All told, nearly six million low-income Americans have been left without any access to affordable insurance whatsoever because of their lawmakers’ continued resistance to fully implementing Obamacare. The fight over Medicaid expansion is disproportionately impacting people of color, who already face significant health disparities compared to their white counterparts in Southern states. Over the past several months, residents in states like Missouri, Virginia, Wisconsin, Georgia, South Carolina, Tennessee, and Texas have risen up to protest their elected officials’ decision to reject the expansion.

On the other hand, in the states that have agreed to expand Medicaid, millions of low-income people are becoming eligible for the public program. The few deeply red states that have accepted the expansion, like Arkansas and West Virginia, are seeing their uninsurance rates plummet.