State’s Policies on Health Care Excludes Some of the Poorest





State’s Policies on Health Care Excludes Some of the Poorest

With the current skyrocketing costs of medical services, more and more are finding it even more difficult to access quality health care. Both federal and state governments are seeking all the possible means of expanding Medicaid for all. Robert Pear in his article, “States’ Policies on Health Care Exclude Some of the Poorest,” has identified how some of the poorest people might be excluded from the Medicaid. Pear first recognizes the majority of states where half of the poorest are found are not ready to expand Medicaid. The article further explains how the new Medicaid will provide insurance coverage to more people as well as the poorest. However, he cites that without most of the states adopting the new Medicaid, the poorest will remain uninsured.

To prove his first point, he makes use of statistical evidence, where he mentioned that 5.7 of uninsured people could be insured only that their states will not be expanding the Medicaid. The author makes sure to provide a detail of the new proposed Medicaid (Pear 2013). Other reasons that the poor might not have access to Medicaid are because they might not be eligible. The article provides the two sides of the issues, where some feel that the poorest will not be eligible for insurance subsidies since it requires a certain amount of money to become eligible. An opposing view feels that even the poorest will receive insurance once the states approve the expansion.

            Throughout the article, the author uses the comments of professionals as well as authorities in the area of healthcare to deliver his point. He shows the different takes from some of the most credible sources concerning the matter. Majority of the people cited in the article is prominent within the healthcare system, such as Sandy Praeger who is an insurance commissioner in Kansas, one of the states that will not be expanding their Medicaid. With such credible people to provide their view concerning the matter, the article becomes quite convincing considering that people trust the comments of leaders more than other people do especially in such a matter. Pear further includes the comments of the administrations officials who think that people will probably blame the president instead of blaming the governors who are refusing to expand their Medicaid. Further, Pear mentions the ruling from the Supreme Court that held it was not a requirement to the states. Rather, the expansion is optional. This explains why it is adopted in some states while others are refusing to adopt it.

            Pear has done quite a great job in highlighting some of the reasons that different states are reacting differently to the Medicaid expansion with evidence of how poorest people will be excluded. I find this to be quite true considering that getting the Medicaid will require an individual to fulfill certain requirements, which majority of the poorest may not. Additionally, some states do not provide Medicaid for adults who are without children, meaning that one will not be considered. This means that all poor adults without children are not eligible for the Medicaid. It is clear that different states have different takes depending on their budgetary circumstances. Some states might have enough to expand the Medicaid while others will put their economy in worse shape by expanding Medicaid considering that in economic crisis times they might be required to provide more for Medicaid while revenues continue to go down. Therefore, each state has the right to expand the Medicaid or not to expand. However, this should depend on the decision that best serves the interest of the residents.

            I do agree with the point Pear makes that the poorest will be excluded from the insurance subsidies and Medicaid. However, Pear is not clear whether the poor will be excluded from both Medicaid as well as insurance subsidies by the refusal of states to expand the Medicaid or by the expanded Medicaid itself. From some of the people quoted in the article, it seems that majority of the poorest people will not be eligible for both Medicaid and insurance subsidies even after expansion. However, the Affordable Care Act Medicaid expansion sought to reduce the number of people that are not insured (FamiliesUSA 2013). The implication is to include even the poorest by offering Medicaid for those living below the poverty line. However, it is now evident that this the people that will be covered even after a state adopts the expansion will depend on the currently level of coverage The Advisory Board Company 2013. Where there are many poor people, it is likely that many will still be excluded even since the state will determine who are eligible. Therefore, Pear did not clearly show that the number of people covered would be dependent on the state and not just whether a state adopts the expansion or not. According to, the impact of the Medicaid expansion will depend on each state (2012).

            Pear has managed to convince the reader that the state policies might exclude the poorest people from Medicaid. therefore, even if states were to adopt the Medicaid expansion, it means some of the states especially ones with the most poor people will still not provide Medicaid and insurance subsidies to the poor ( 2013). This is because the Medicaid is dependent on each state’s policies as the title of the article suggests. In fact, except for the lack of clarification on whether it is lack of adopting the expansion or the state itself that brings about the difference, Pear succeeds in convincing the reader how the poorest people are excluded from the Medicaid by state policies. Much of the convincing in this article from the sources used, especially the authorities and professionals’ comments on the issues. In entirety, the author achieves his purpose of convincing the reader how the poorest people will be excluded from Medicaid by the states’ policies. 

Works Cited

FamiliesUSA. Premium Assistance in Medicaid and CHIP: An Overview of Current Options and Implications of the Affordable Care Act., March 2013. Web. June 24, 2013. The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis., November 1, 2012. Web. June 24, 2013. affordable care act., 2013. Web. June 24, 2013.

Pear Robert. States’ Policies on Health Care Exclude Some of the Poorest., May, 24, 2013. Web. June 24, 2013. 

The Advisory Board Company. Where Each State Stands On ACA’s Medicaid Expansion., June 14, 2013. Web. June 24, 2013.

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