The wack job governor of Florida, Richard Scott, is saying that his state is not going to seek out the 100% federally-paid-for Medicaid Expansion when the Affordable Care Act (“Obamacare”) calls for it in eighteen months. (January 1, 2014)
This expansion of the program to provide health care to low-income residents was meant to cover all Americans without a health insurance alternative, who made under 133% of the federal poverty level (FPL).
(In some places, you read 138%, and I think that number accurately includes some administrative leeway. The 133% is the figure you see so much, though.)
The health care insurance exchanges (“Exchanges”) were meant for everyone between 133% and 400% of FPL. Four hundred percent is a big number, like $44,000 for a single or $92,000 for a family of four.
The question I have is: if a state does not expand its Medicaid, does a person under 133% of FPL go to the federally mandated exchange? If so, what is the cost of insurance to them?
At 133%, for a single person, it looks like the amount is $25 a month. Could someone at less than 133% of FPL get the same policy for $25?
Since the Exchange policies will be subsidized—similar to how employer-provided health insurance is tax free–does it matter if a state does not take the Medicaid Expansion money, since they would then be getting subsidized policies out of the Exchange?
Don Berwick, the former head of Medicare and Medicaid, didn’t have the answer to this on a talking-head politics show. If he doesn’t know, I wonder if there is an answer. I wonder if the Obama Administration can just rule on it before January 2013, or later, if he wins again as looks likely.