Third and State

Pennsylvania is not the only state undecided about whether to expand Medicaid health coverage to low-income working families. As The Washington Post reports: 

Twenty states and the District of Columbia have signed on to the expansion, and 14 are planning to decline. But 16 [including Pennsylvania] remain in limbo as lawmakers clash in the final days and weeks of the legislative calendar, when many must come to a decision in time for the provision to kick in next year.

We have blogged (here and here) in recent weeks about reports showing how an expansion of Medicaid will benefit Pennsylvania residents both from an economic and public health standpoint.

One aspect of the debate that has not gotten as much attention is that an expanded Medicaid is the only option for many low-income working Pennsylvanians.

Beginning in 2014, federal tax credits will help working families in Pennsylvania afford private coverage purchased through a new health insurance marketplace created by the Affordable Care Act. However, Pennsylvania families earning less than the federal poverty level will only qualify for health coverage if the state accepts federal funding to expand Medicaid.

That's because families with incomes of less than 100% of the federal poverty guidelines ($23,550 for a family of four) will not be eligible for tax credits under the Affordable Care Act. For those families who have some income from work but cannot afford to buy insurance out of pocket, an expansion of Medicaid is their only hope for health coverage.

Along with the economic benefits that expansion brings, the choice should be clear for state policymakers.

As the Washington Post notes:

Business groups say the huge influx of federal money would be a financial windfall for the states. And health-care advocates point out that, in states that choose not to expand, the people left out will probably be fast-food employees, grocery store cashiers, construction workers and other very low-wage earners- millions of people who were supposed to be some of the prime beneficiaries of reform.