5 million left out of Medicaid expansion

Amber Sanchez, a San Francisco cancer survivor, skipped visiting the gynecologist last year to check a growth on her ovary because she was uninsured. This year, it’s at the top of her New Year’s plans.
The difference: As of Jan. 1, the 27-year-old is eligible for California’s Medicaid expansion under Obamacare.

In Alabama, which rejected the expansion, Jefferica Poindexter isn’t so lucky. Dealing with high cholesterol, chronic sinus pain and a bad back, she depends on emergency rooms and nonprofit clinics -- when they can see her.

“I’ve tried to go the clinic,” said Poindexter, who is 63. “They’re already booked by the time they get to me.”

The women’s fates are the consequence of a political debate that’s divided the U.S. roughly along party lines: Democratic-led states have expanded Medicaid programs for the poor under the health law; most Republicans have refused. While the law’s online exchanges draw more scrutiny, it’s Medicaid that may determine the health of millions of Americans. The expansion is one of the twin pillars created by the law to supply medical care to the nation’s uninsured, complementing subsidies for private insurance.

Still, with only 25 states choosing to participate in the expansion, almost 5 million people will be left out, according to the Kaiser Family Foundation, which studies health policy.