Under the Patient Protection and Affordable Care Act, Medicaid expansion is mostly left up to state governments, making "the choices voters make to fill governor's mansions and state legislatures" decisions that will have "just as big an effect on what kind of health coverage they will have in coming years," Maggie Fox of NBC News reports.
Two states are at the extremes of the debate: Texas, which has "free-market, bare-bones" health care, and Vermont, "which is unabashedly going for a European-style, government-supported system," Fox reports. There are 6.3 million people in Texas without health insurance, which is about a quarter of the state's population, giving it the highest percentage of uninsured in the U.S. Gov. Rick Perry has said he won't expand Medicaid, despite heavy federal incentives, and the Republican-dominated state legislature turned down $76 billion in matching federal funds that would have helped expand coverage.
In Vermont, Democratic Gov. Peter Shumlin and the legislature want a "single-payer system that they say will give them the leverage to lower prices and provide better care for everyone in the state," Fox reports. But they don't yet have the votes to make this happen. This year's state election will decide in which direction health care moves.
The Affordable Care Act was designed to force state expansion of Medicaid to give healthcare to about 16 million more of the county's poorest people. But the Supreme Court decided in June that the law went too far on this, and ruled that states could opt out of expansion, losing all federal matching dollars that would have come with it. "So now two of the biggest provisions of the law -- offering Medicaid to more people and setting up the health exchanges -- are in the hands of state officials," Fox reports, which makes this year's state elections vital in terms of healthcare. (Read more)
Two states are at the extremes of the debate: Texas, which has "free-market, bare-bones" health care, and Vermont, "which is unabashedly going for a European-style, government-supported system," Fox reports. There are 6.3 million people in Texas without health insurance, which is about a quarter of the state's population, giving it the highest percentage of uninsured in the U.S. Gov. Rick Perry has said he won't expand Medicaid, despite heavy federal incentives, and the Republican-dominated state legislature turned down $76 billion in matching federal funds that would have helped expand coverage.
In Vermont, Democratic Gov. Peter Shumlin and the legislature want a "single-payer system that they say will give them the leverage to lower prices and provide better care for everyone in the state," Fox reports. But they don't yet have the votes to make this happen. This year's state election will decide in which direction health care moves.
The Affordable Care Act was designed to force state expansion of Medicaid to give healthcare to about 16 million more of the county's poorest people. But the Supreme Court decided in June that the law went too far on this, and ruled that states could opt out of expansion, losing all federal matching dollars that would have come with it. "So now two of the biggest provisions of the law -- offering Medicaid to more people and setting up the health exchanges -- are in the hands of state officials," Fox reports, which makes this year's state elections vital in terms of healthcare. (Read more)
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