The states that are refusing to expand Medicaid money under the Affordable Care Act aren't just going to be
losing billions in Medicaid money, they'll be losing funds that have been provided by the federal government to community health centers as a bridge until Obamacare is fully implemented in 2014. At that time, expanded Medicaid was
supposed to cover the population relying on the community health centers. But that's a population that will now be left out in the cold in states that aren't expanding Medicaid, unless Congress acts to extends the funding for community programs.
Here's what will happen in Michigan, as an example.
More than 150,000 Michiganians stand to lose health coverage if the state Legislature fails to expand Medicaid coverage.
The low-income residents are covered by county health plans that provide last-resort medical care for childless adults. But federal funding for the plans will start to dry up in 2014 under the Affordable Care Act. [...]
The two main sources of federal funding for the county plans will be rolled back by the government starting in 2014 under the Affordable Care Act. The law, called "Obamacare" by some, anticipated the funds would no longer be needed because of the Medicaid expansion.
And in another twist, the Affordable Care Act also blocks people at or below the poverty line from obtaining coverage on state health care exchanges, an Internet insurance marketplace for the uninsured. That's because Obamacare assumed that all of these people would be covered by the Medicaid expansion.
President Obama has asked Congress to extend the funding to prevent this gap in all the states where Medicaid won't be expanded to pick up what will be hundreds of thousands of people caught in the gap. The question is, does Congress give a damn? In the meantime, Michigan's legislature is still trying to figure out whether to take the Medicaid money.