An article in Friday's New York Times describes how, in the states which refuse Medicaid expansion under the Affordable Care Act, the poorest of the poor will receive no new help to obtain health insurance, while the slightly less poor will be eligible for federal tax credits to subsidize health insurance premiums. This is how it will work, according to the Kansas Insurance Commissioner:
Sandy Praeger, the insurance commissioner of Kansas, said she would help consumers understand their options. She said, however, that many of “the poorest of the poor” would fall into a gap in which no assistance is available.
The Kansas Medicaid program provides no coverage for able-bodied childless adults. And adults with dependent children are generally ineligible if their income exceeds 32 percent of the poverty level, Ms. Praeger said.
In most cases, she said, adults with incomes from 32 percent to 100 percent of the poverty level ($6,250 to $19,530 for a family of three) “will have no assistance.” They will see advertisements promoting new insurance options, but in most cases will not learn that they are ineligible until they apply.
This is just crazy in terms of any sort of public policy. But refusing Medicaid expansion under the ACA should also be called out for what it is: an act of breathtaking cruelty.