That part confuses me too. Obamacare has a wage minimum in order to qualify for medical insurance.
You would think that anything below that falls into the Medicaid category. However, states have their own Medicaid rules for income levels and who qualifies.
When they talk about Medicaid expansion, I believe the ACA assumed that all states would cover the gaps between the states maximums and the Federal's minimum.
Apparently not. There is a gap there where some people who make above their states maximum level and below the Federal minimum level.
Part of the ACA was to pay for those in the gaps for three years, but after that, the states would have to pick them up. Some states have figured out that their budgets just can't afford it.
Medicaid is an enormous local budget buster,many states pass much or all the costs to the county governments.
On Fox the other night they were saying that the only thing covered by the 3 years of "free" federal money is entirely brand new Medicaid recipients.
The upshot of that is those who may have already at one time been on the rolls do not get covered by expansion funds but entirely by the state.
No idea on that,can`t find anything online about it.
Regardless,in 3 years the Feds start reducing the money to eventually a point of states picking up 10% of the tab by 2017.
This was interesting...
The Federal Government pays 100% of expansion costs for the first three years and 90% thereafter until 2022.
http://obamacarefacts.com/obamacares-medicaid-expansion.php
What happens after 2022?
Everything I can find online uses an assumption that expanding Medicaid will lower health care costs so as to be a net benefit to the state.
Common sense and past history show this to be a baseless theory in my opinion.
It presumes all usage will be vital and preventative.
Observations have shown it increases usage for non vital care as the general feeling becomes that it the same as personally purchased insurance.
The tendency to use it for every sniffle increases and the preventative benefit can never be proven.