The Supreme Court Decision and Medicaid Expansion

The big news last week was that the U.S. Supreme Court ruled that the individual mandate clause of the Affordable Care Act is constitutional. They also ruled that the federal government cannot impose the law’s Medicaid expansion component on states, meaning that states that want to limit their expenditures can opt-out of the expansion, although it would be overwhelmingly paid for by the federal government. Seven states, including Florida, Iowa, Louisiana, Mississippi, South Carolina, Texas, and Wisconsin, have governors who have already announced that they’re considering opting out of the expansion (Wall Street Journal Article). The expansion would provide insurance for those earning up to 133% of the federal poverty level. Particularly outspoken has been Florida Governor Rick Scott, who said in a statement, “Since Florida is [now] legally allowed to opt-out, that’s the right decision for our citizens.”

According to Census data available on PolicyMap, Florida has the third-highest percentage of people at or below 200% of the poverty level who don’t have health insurance (as of 2009). Texas, which is also considering opting out, is ranked number one. In those states, 39.2% and 41.7% of these people lack health insurance. The data reflects a time period three years ago, but it’s the latest nationwide data on the uninsured population. You can look on PolicyMap to see how Medicaid expansion (or lack thereof) will affect where you live. Zoom in to see county-level data.