As the Affordable Care Act’s health insurance marketplaces prepare to open for business across the country, former President Bill Clinton is urging Congress and the states to fix some glaring glitches.
Speaking at his presidential library in Little Rock, Ark., Clinton touted the ACA’s early successes and future benefits, while pointing to some challenges he says still need to be addressed.
One of the law’s worst problems, he says, is an unintended consequence of the Supreme Court’s ruling upholding the health law but making the expansion of Medicaid optional for states. In about half of the states, governors and lawmakers have chosen not to expand Medicaid to low-income adults with incomes up to 138 percent of the federal poverty level.
In those states, Clinton explained, working people with incomes below the federal poverty level ($11,490 for an individual) will not be eligible for Medicaid or federal subsidies. “So you get the worst of all worlds,” he says. “You’re working 40 hours a week, but you’re too poor to get help. Not too rich, but too poor.”
Meanwhile, people in those same states who make higher incomes will get federal tax subsidies to help pay for health insurance.
“This is a problem that only states can fix,” Clinton says. While not offering a specific solution, he said states are “going to have to talk about it.” Besides leaving the poorest Americans without health coverage, he said, states’ decisions not to expand Medicaid will hurt the hospitals within their borders that end up caring for the poor.
Clinton spoke as part of what the White House has billed as a “celebrity outreach effort” to help Americans understand what the law has to offer them.
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