Many of the provisions of the Patient Protection and Affordable Care Act (“PPACA”) are set to go into effect at the end of this year, including the expansion of Medicaid. After the Supreme Court held that states could not be forced to expand their Medicaid offerings, the provision has become a lightning rod for both opponents and supporters of the PPACA. As a result, the PPACA is off to a tepid reception.
According to an analysis by the New England Journal of Medicine, the governors of 22 states, including four Republicans, are in favor of the Medicaid expansion contained in the new health care reform law; on the opposite side of that spectrum are at least 13 Republican governors standing in ardent opposition to the Medicaid expansion. What this means is that when the law does go into effect, there will be large portions of low-income adults that are ineligible for any publicly subsidized health insurance (i.e., Medicaid). The reason for this is that, contrary to popular belief, Medicaid does not provide coverage to all of the nation’s poor and impoverished because a vast array of regulations and restrictions wind up limiting Medicaid’s availability to women who are pregnant and children.
The PPACA’s Medicaid expansion was designed to add 16 million uninsured people into the United States’ health care system, but whether that actually occurs will depend upon which states agree to the expansion. Although opposition by a state’s governor doesn’t mean the expansion will be rejected, it does prognosticate the states likely stance.