”You fall through the cracks and there’s nothing you can do about it.  It makes me feel like garbage, like the American dream, my dream in my homeland is not being accomplished.”
~Sandra Pico, an American citizen 

Sandra Pico is a 52 year old mother who makes $15,000 a year and doesn’t qualify for Medicaid in Florida because the most you can make and still qualify for Medicaid per state law is $14,999 a year.

CBS shares another story from a woman in Texas who is having to go to food banks in order to feed her family:

In Texas – if you make $8.00 an hour and work only 12 hours a week, each week for an entire year … you make too much to qualify for Medicaid.  Seriously.  Every single state is able to manage its own Medicaid program differently and because of that … there are horrible inequities within the system.  Some states manage Medicaid better than others.  Now Obamacare set to help address that problem by paying for 90% of the costs that states shoulder with states having to pick up 10% of the costs associated with Medicaid patients.

When the Supreme Court found Obamacare to be constitutional – there was only one element of the law they ruled unconstitutional.  They essentially ruled that the federal government can not penalize states by withholding Medicaid funding if states decide not to sign on to the Medicaid expansion.

Historically – the federal government has done this for a whole host of things.  One example – states have reduced their maximum speed limit because the federal government said that if speed limits exceeded X miles per hour – they would lose ALL of their transportation funds.  Every president has done this in some way with some program and I would say that it was the right decision to make it illegal for the federal government to basically extort the states to do what they want.  We wrote about that HERE.

But – relative to this Medicaid discussion … this leaves states being able to opt out of expanding eligibility in Medicaid which was the primary driver for the nearly “universal healthcare” portion of the healthcare law.  So – now … even though states will receive 90% of the funding from the federal government and only have to pay for 10% of the bill – Republican Governors throughout the country have promised to stop the tyranny that is giving poor people access to healthcare that they otherwise couldn’t afford.

Think Progress explains how Obamacare is going to affect Medicaid for Governors who do not reject federal funds HERE:

Obamacare establishes a new eligibility level for Medicaid above the current poverty line of $18,530 for a working family of three. Effective in 2014, the expansion will allow families who make up to $26,344 to be eligible for coverage under the program. That would make a huge difference for low-income working families in states like Florida, South Carolina, Georgia, and Louisiana who are not currently considered poor enough to qualify despite the fact that they are living in poverty by federal standards. However, those states’ Republican governors are choosing to deny their state’s low-income residents health care coverage.

If governors reject the ACA’s Medicaid expansion, the families whose income falls between the federal poverty line and the new $26,344 income level may receive subsidies to help them participate in the health insurance exchanges that will be set up in 2014. But the estimated 11 million families who fall under the poverty line but above their state’s Medicaid eligibility line will be left in the cold, unable to receive either Medicaid benefits or subsidies.

And CBS gives some insight into how the plans for Obama and the Ryan plan that Romney has embraced differ HERE:

Many of the people affected by the decision are working parents who are poor — but not poor enough — to qualify for Medicaid.

Republican Mitt Romney’s new running mate, conservative Wisconsin congressman Paul Ryan, has a budget plan that would turn Medicaid over to the states and sharply limit federal dollars. Romney hasn’t specifically said where he stands on Ryan’s idea, but has expressed broad support for his vice presidential pick’s proposals.

Medicaid now covers an estimated 70 million Americans and would cover an estimated 7 million more in 2014 under the Obama health law’s expansion. In contrast, Ryan’s plan could mean 14 million to 27 million Americans would ultimately lose coverage, even beyond the effect of a repeal of the health law, according to an analysis by the nonpartisan Kaiser Family Foundation of Ryan’s 2011 budget plan.

For now, most states don’t cover childless adults, but all states cover some low-income parents. The income cutoff, however, varies widely from state to state.

And as we’ve written about HERE – cutting off funding for Medicaid is cutting funding for the disabled and children:

But as we’ve shown HERE - the Ryan Plan which Romney says he would sign if he were President and acknowledges that his own plan would be very similar would have draconian cuts to Medicaid by 1/3 in addition to eliminating the additional funding provided for Medicaid in Obamacare.  Just look at this graph below to see what I mean.  The bar on the right is the amount of money the federal government would allocate for Medicaid via the Ryan plan as compared to the other bars which show our existing pace:

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