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Covering Low-Income Midlife Adults Through Medicaid: Making Progress, but More States Need to Take the Plunge


The Affordable Care Act — as interpreted by the U.S. Supreme Court — gives states the option to expand Medicaid. Access to Medicaid significantly reduces the number of uninsured in this country. Since the expansion began, millions of individuals are receiving coverage through Medicaid or the Children’s Health Insurance Program. Yet, 19 states have not expanded Medicaid coverage, potentially leaving almost 2 million low-income midlife adults (ages 45-64) without access to insurance coverage.

Being uninsured is especially hard on adults in their middle years who are experiencing the onset of chronic illness, like diabetes and hypertension. These conditions are treatable with sustained access to primary care. Left untreated, they worsen, leading to debilitating side effects (like loss of a limb or stroke) and high emergency room and uncompensated care costs.

Here are the numbers of midlife adults who are potentially going without health insurance coverage in states that have chosen not to expand their Medicaid programs:

Alabama                                80,144

Florida                                  397,327

Georgia                                173,952

Idaho                                     26,398

Kansas                                  30,442

Maine                                     14,187

Mississippi                            57,697

Missouri                                86,978

Nebraska                               19,173

North Carolina                    146,882

Oklahoma                            57,220

South Carolina                    85,390

South Dakota                      12,149

Tennessee                          108,785

Texas                                   427,566

Utah                                      21,414

Virginia                                89,278

Wisconsin                            51,841

Wyoming                               7,429      

Total                                  1,894,252




Lynda Flowers is a senior strategic policy adviser specializing in Medicaid issues, health disparities and public health.





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