Some 5.2 million Americans, including 194,330 South Carolinians, won’t qualify for either Medicaid or subsidies to purchase insurance under the Affordable Care Act, the Kaiser Family Foundation said Wednesday.
Under the new law, most people must purchase insurance or pay a penalty beginning in January.
Those making up to 138 percent of the federal poverty level — or $15,856 for an individual and $26,951 for a family of three, according to Kaiser — were supposed to be covered by an expansion of the federal Medicaid program.
But the Supreme Court ruled that states could decide whether to expand or not. And in states that didn’t expand, like South Carolina, these people aren’t eligible for Medicaid or fall below 100 percent of poverty line and are therefore ineligible for coverage under the law, also known as Obamacare.
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South Carolina opted not to expand, saying it would be financially irresponsible to fund permanent programs with temporary dollars. It estimates some 200,000 residents will fall into the gap.
The ACA subsidies to help people purchase private coverage on the health care marketplace are reserved for those earning from 100 percent to 400 percent of the federal poverty level, or $11,490 to $45,960 for an individual, and $19,530 to $78,120 for a family of three, Kaiser reports.
The 5.2 million live in the 26 states that aren’t expanding Medicaid, Kaiser said. And the gap ranges from more than 1 million in Texas and 763,890 in Florida to 409,350 in Georgia and 17,290 in Alaska.
The South Carolina number represents 33 percent of the state’s uninsured adult population. And the share ranges from 18 percent in Alaska to 37 percent in Mississippi, Kaiser reports.
In the 26 states that aren’t expanding, nearly all childless adults are ineligible for Medicaid along with parents whose incomes are above current eligibility levels, Kaiser reports.
Southern states are disproportionately affected, as are people of color, because they are more likely to be uninsured, low-income, and work in low-wage jobs that don’t offer insurance, Kaiser said.
The statistics don’t include undocumented immigrants or legal immigrants in the U.S. less than five years.
Kaiser is a nonprofit independent health policy think tank.