Obamacare May Be Torpedoed By States Opting Out of Medicaid Expansion

A rickety program gets worse

Nearly 2 in 3 uninsured low-income people who would qualify for subsidized coverage under President Barack Obama's health care law may be out of luck next year because their states have not expanded Medicaid.

An Associated Press analysis of figures from the Urban Institute finds a big coverage gap developing, with 9.7 million out of 15 million potentially eligible adults living in states that are refusing the expansion or are still undecided with time running short.

That a majority of the neediest people who could be helped by the law may instead remain uninsured is a predicament unforeseen by Obama and congressional Democrats who designed a sweeping extension of the social safety net. The law's historic promise of health insurance for nearly all U.S. residents would not be fulfilled as envisioned.

It's the direct consequence of last summer's Supreme Court decision that gave states the right to opt out of the Medicaid expansion, combined with unyielding resistance to the law from many Republican state lawmakers.