Economists believe that a global recession is unavoidable amidst the Coronavirus crisis, and there are already reports of large spikes in unemployment. Since the health insurance of many Americans is tied to their employment, the US is likely to also see large increases in uninsured people with newly lower incomes. The 15 states that have not yet expanded Medicaid eligibility under the Affordable Care Act are least prepared to assist the many workers expected to simultaneously lose their jobs and their health insurance coverage. Medicaid enrollment is not limited to a narrow open enrollment period (as is the case with most private insurance), so eligible people can enroll at any time during the year. Subsidized Marketplace insurance is limited to those with incomes between 100 and 400 percent of the federal poverty level, meaning that losing a job and family income in a nonexpansion state will leave many with no affordable or accessible insurance options. This dire situation may be sufficient impetus for at least some of the remaining states to expand Medicaid eligibility. This brief explores the potential for the remaining 15 states to expeditiously implement a Medicaid expansion and describes the potential barriers to doing so.
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