Most cruelly, many of the states that have refused to accept the Medicaid expansion are those where Medicaid benefits are most stingy to begin with. Each state sets its own eligibility levels, and not too surprisingly, states run by Republicans tend to set them extremely low. So for instance, if you’re a single parent in Alabama with two kids and you earn a princely $3,221 a year, the state considers you too wealthy to get Medicaid. In Texas, which has more people living without health insurance than any other state, that figure is $3,737. Millions of the working poor could have gotten coverage from Medicaid through the expansion, but their state legislators and governors quite literally believe that it’s better for a poor person to have no health coverage at all than to get coverage from the government.
 
By one analysis, 5.2 million Americans who could have gotten Medicaid if their states had accepted the expansion will remain uninsured. And if you asked those people in a poll whether Obamacare had helped them, they’d quite reasonably say no.
 
So Republicans in those states can laugh all the way to election night. They got to screw the poor, which, let’s be honest, they were inclined to do anyway, and in doing so they also did political damage to the Obama administration. Quite a trick.
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