The GOP’s refusal to fully implement the Affordable Care Act will leave more than half of the nation’s uninsured working poor without access to health insurance and will also disadvantage military veterans.
While the health care law does not change the Veterans Health Administration or other military health care systems, the ACA does expand Medicaid to all uninsured Americans with incomes below 133 percent of the federal poverty line and could provide health care coverage to nearly half of all uninsured veterans. This population of approximately 1,314,000 veterans tends to “have served more recently, are younger, have lower levels of education, are less likely to be married, and are less connected to the labor force.” (According to a2012 analysis from the Urban Institute, 48 percent of uninsured veterans are estimated to have incomes below the Medicaid eligibility threshold.)
Half of veterans who are insured, but report only relying on the Veterans Administration for their health care needs, could also “qualify for Medicaid to supplement their VA care under the expansion,” the analysis found.
Unfortunately, the states that have failed to grow Medicaid are home to higher rates of uninsured veterans than the states that expanded their programs. A ThinkProgress analysis of Urban Institute data found that the average rate of uninsurance among veterans in the 24 states that have not expanded Medicaid is 12 percent, while states that did expand Medicaid have an average veteran uninsurance rate of 9 percent.
The gap is the result of a 2012 Supreme Court ruling that upheld the constitutionality of the ACA’s individual mandate, but permitted states to refuse to expand Medicaid. Many of the states that turned down the program — Texas, Louisiana, Florida, South Carolina, Mississippi, and Georgia — already suffer from the highest uninsured states in America and are less likely to provide government assistance in obtaining insurance than states that have agreed to increase Medicaid eligibility.
Under reform, adults who earn less than the federal poverty line will still lack affordable coverage options, while individuals and families above the threshold will be eligible to purchase subsidized coverage in the law’s new health care marketplaces. The Urban Institute estimates that 40.1 percent of uninsured veterans have incomes that could qualify them for tax credits under the law.
Republicans argue that expansion would cost their states millions, even though the federal government will pick up nearly all of the costs of coverage (100 percent for the first three years, phasing down to 90 percent in 2020 and all subsequent years), paying nearly 93 percent the cost over the next nine years, according to the Congressional Budget Office.