Medicaid Expansion

April 2013

It is from your hands that Our Lord, in the person of the sick, seeks relief.        St Vincent de Paul

As part of the Affordable Care Act (ACA), states have the option of accepting billions of federal dollars to provide health coverage for their uninsured working adults. Unfortunately, due to political gamesmanship, the Working Poor are being denied this chance to live with the security and dignity that God intends for Them. The Ladies of Charity have partnered with NETWORK, A National Catholic Social Justice Lobby, the Saint Vincent de Paul Society and various coalitions throughout the country to persuade governors to accept federal funding that will ensure Medicaid eligibility for the working Poor of our nation.

Last year, the Supreme Court upheld the constitutionality of the Affordable Care Act but it also held that expanding Medicaid to include those who earn up to 138% of the federal poverty level (FPL) cannot be mandatory for states. Tragically, if a state doesn’t expand Medicaid in 2014, there will be no valid health insurance option for many low-income people who earn between 100 and 138% of the federal poverty level (FPL) .  Pursuant to the ACA, the Federal Government will cover 100% of the costs for the initial three years, tapering to and freezing at 90% of the costs by 2021. The federal funding will never be less than 90% and it ensures Medicaid coverage for people who earn less than 138% of the FPL.

This federally funded improvement will provide millions of hard‐working families preventive care and the ability to see a doctor promptly, as needed, instead of ending up in the emergency room. Collateral bonuses of expansion include economic stimulus from the infusion of millions of dollars into the states; job creation for healthcare and companies that support health care; and a more productive, healthy work force. While there is no deadline to opt in to the improved Program, the 100% match only applies to the years 2014, 2015 and 2016. A governor that delays participation by even one year will forever deny the state of the millions of dollars that it would reap in the first year. Nevertheless, if a governor does not accept this year, he can opt in at any point and start providing adequate medical coverage for His Poor.

The LOC are linked through NETWORK with 15 state based teams and we have experienced great success.  So far, 25 governors have accepted the federal funding, including 8 republican governors. Sadly, fourteen governors have rejected the influx of money and the opportunity to insure the working Poor who cannot afford health coverage but earn too much money to be eligible for Medicaid under the current standards.  These governors need to hear and properly respond to the cries of their Working Poor. The remaining governors have not committed to a clear choice.

For more information related lobby efforts for accepting the millions offered to your state and providing healthcare coverage for those who earn less than 138% of the FPL, see

Author, Sr. MaryEllen Lacy, DC, NETWORK, Inc., a member of the advocacy committee of LCUSA.