The big news yesterday was the U.S. Supreme Court ruling on the Constitutionality of the Affordable Care Act (Obamacare). The big picture was, SCOTUS upheld it - most of it, in a 5-4 verdict. But there was one part of the act, the Medicaid expansion, where 7 justices agreed that this was basically a new program, and existing Medicaid funds could not be taken back by the federal government if states declined to comply, has the most near-term consequences for health care itself.
Given that Medicaid expansion created half of the coverage increases in the bill, this offered half of the states the opportunity to really take an axe to the program by simply refusing to expand their Medicaid programs. And it leaves the poor between around 50% and 133% of the poverty line in a real no man’s land, because they would both be ineligible for Medicaid AND the coverage subsidies in the exchanges.
Some Democrats - Nancy Pelosi being the most notable - say that Republican governors would be foolish to refuse to expand their Medicaid programs. That, of course, doesn't mean they won't do it.
What would the impact be? And bear in mind the majority of states now are run by Republicans, many who were swept in on the anti-Obamacare wave of 2010. It's pretty clear that a decision not to expand Medicaid would have drastic consequences for people of color. Here's why:
Medicaid remains a bitterly fought over program today. The ruling yesterday will make it more so.
For people of color, the impact of the mess that the court just rolled down Pennsylvania Avenue and out into the country cannot be understated. Blacks, Latinos and Asians are up to three times less likely to have insurance than whites. Half of the nation’s uninsured are people of color.
The Center for American Progress estimates that this racial gap in health care coverage costs the country $415 billion a year in lost productivity.
For black and brown America, affordable, quality healthcare is key to closing a wider economic gulf.
...
Medicaid is a mitigating force in this lopsided system. Blacks and Latinos are enrolled in Medicaid at twice the rate of whites. Half of those in the program are children. As the Kaiser Family Foundation has bluntly concluded, “Medicaid enables Black and Hispanic Americans to access health care.”
And there you have it. The jobless recovery has made the situation worse. Three out of four people who lose their job, also lose their insurance. As a result, the number of people in Medicaid has soared to 60 million.
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