Republican Opposition Cuts Obamacare’s Benefit to Blacks

BIRMINGHAM, AL - NOVEMBER 04: Two African-Americans women vote in a recreation center in the presidential election November 4, 2008 in Birmingham, Alabama. Birmingham, along with Selma and Montgomery, were touchstones in the civil rights movement where Dr. Martin Luther King Jr. led massive protests which eventually led to the Voting Rights Act of 1965 ending voter disfranchisement against African-Americans. Americans are voting in the first presidential election featuring an African-American candidate, Democratic contender Sen. Barack Obama, who is running against Republican Sen. John McCain.
National Journal
Clara Ritger
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Clara Ritger
Dec. 10, 2013, midnight

More than 2.2 mil­lion Afric­an-Amer­ic­ans liv­ing be­low the fed­er­al poverty line won’t have ac­cess to Obama­care’s in­sur­ance be­ne­fits due to the slew of states that op­ted out of the law’s Medi­caid ex­pan­sion.

Had all 50 states ex­pan­ded Medi­caid, 95 per­cent of un­in­sured Afric­an-Amer­ic­ans would be eli­gible for some form of fed­er­al as­sist­ance through the Af­ford­able Care Act cov­er­age — either via Medi­caid or premi­um sub­sidies — ac­cord­ing to a Health and Hu­man Ser­vices re­port re­leased Monday. In­stead, only 60 per­cent will be­ne­fit.

In total, 25 states chose not to ex­pand Medi­caid, cre­at­ing a “cov­er­age gap” where some res­id­ents earn too much to qual­i­fy for the pro­gram but not enough to qual­i­fy for the tax cred­its. Those cred­its are gran­ted to in­di­vidu­als and fam­il­ies earn­ing between 100 and 400 per­cent of the fed­er­al poverty level.

The Af­ford­able Care Act ori­gin­ally re­quired all states to ex­pand Medi­caid cov­er­age to Amer­ic­ans earn­ing be­low 138 per­cent of the fed­er­al poverty line or for­feit their fund­ing for the pro­gram al­to­geth­er, but the Su­preme Court deemed that pro­vi­sion un­con­sti­tu­tion­al. With the de­cision left to the states, a ma­jor­ity with Re­pub­lic­an gov­ernors op­ted out of the ex­pan­sion, as did three that have Demo­crats at the helm: Mis­souri, Montana, and New Hamp­shire.

Des­pite only half the states ex­pand­ing Medi­caid, 6.8 mil­lion un­in­sured Afric­an-Amer­ic­ans are eli­gible for Af­ford­able Care Act cov­er­age, with 4.2 mil­lion able to re­ceive tax cred­its or en­roll in Medi­caid or the Chil­dren’s Health In­sur­ance Pro­gram.

More than half of all eli­gible un­in­sured Afric­an-Amer­ic­ans live in fam­il­ies whose in­come falls be­low the fed­er­al poverty line. Two-thirds of the total eli­gible pop­u­la­tion, however, resides in states that op­ted not to ex­pand Medi­caid.

Eli­gible un­in­sured Afric­an-Amer­ic­ans tend to reside in South­ern states or met­ro­pol­it­an areas, the HHS re­port found.

Some 34 per­cent live in four states — Flor­ida, Geor­gia, Texas and North Car­o­lina — not ex­pand­ing Medi­caid, with 10 per­cent in Flor­ida alone. Four in ten live in just 20 met­ro­pol­it­an cit­ies, with the highest con­cen­tra­tions in At­lanta, New York, and Chica­go.

For those who do earn enough to qual­i­fy for tax cred­its, the fed­er­al as­sist­ance can go a long way. In Jack­son­ville, Fla., a fam­ily of four earn­ing $50,000 a year could pur­chase a mid-grade plan for as little as $282 per month. Without sub­sidies, that plan would carry a monthly premi­um of $709.

A “bronze” plan, the low­est cost op­tion, car­ries a $36 price tag after sub­sidies.

HHS es­tim­ates 41.3 mil­lion Amer­ic­ans are un­in­sured and eli­gible for Af­ford­able Care Act cov­er­age. Afric­an-Amer­ic­ans make up 16 per­cent of that pop­u­la­tion. They also have a high­er un­in­sured rate than the gen­er­al U.S. pop­u­la­tion at 20 per­cent, com­pared with 16 per­cent over­all.

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