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I do not understand your second reason. > So in more than half the states people making just above a certain threshold get essentially free healthcare, while p

I do not understand your second reason. > So in more than half the states people making just above a certain threshold get essentially free healthcare, while people making below it get nothing. In these states ACA has done almost nothing to help the very poorest. The ACA, by itself, has done everything it could have to help the poorest, within the options that would actually pass the US congress (2009-2010). The Supreme Court said the ACA could not force the states to take the (federally funded) Medicaid expansion, so the state governments used that choice as a political party loyalty test. The state governments chose to refuse preallocated federal money, to help the poor, to show their loyalty for the next election cycle. I too would have preferred a single payer system, but the ACA is what passed and the state governments have made their choice.

learc83 12y ago
>The Supreme Court said the ACA could not force the states to take the (federally funded) Medicaid expansion The medicaid expansion is only fully federally funded for the first 3 years. It goes down to 90% by 2020 (Edit: I originally wrote 2014), and could very easily be pushed below that later on--Republican governors used that as an excuse not to expand. I think they could have passed a bill that either allowed people making below the poverty level to use the exchanges with subsidies or they could have fully funded the medicaid expansion. I really don't think adding a small fractional increase in total cost would have killed the bill.
- jared314 12y ago
  > It goes down to 90% by 2014, and could very easily be pushed below that later on--Republican governors used that as an excuse not to expand. It is phased down to 90% by 2020, and, in its current form, doesn't fall below that. The phasing just starts in 2014.
  - learc83 12y ago
    Sorry that was a typo.

learc83 12y ago

>The Supreme Court said the ACA could not force the states to take the (federally funded) Medicaid expansion The medicaid expansion is only fully federally funded for the first 3 years. It goes down to 90% by 2020 (Edit: I originally wrote 2014), and could very easily be pushed below that later on--Republican governors used that as an excuse not to expand. I think they could have passed a bill that either allowed people making below the poverty level to use the exchanges with subsidies or they could have fully funded the medicaid expansion. I really don't think adding a small fractional increase in total cost would have killed the bill.

jared314 12y ago
> It goes down to 90% by 2014, and could very easily be pushed below that later on--Republican governors used that as an excuse not to expand. It is phased down to 90% by 2020, and, in its current form, doesn't fall below that. The phasing just starts in 2014.
- learc83 12y ago
  Sorry that was a typo.