Obamacare leaves many of the poorest Americans at risk of remaining uninsured

The Supreme Court may have upheld health care reform, but the ruling has left many of the poorest Americans at risk of remaining uninsured. The justices' decision Thursday kept in place nearly all of the Affordable Care Act's provisions, including the mandate that all consumers buy health insurance by 2014 or pay a tax. Also upheld was a provision that expands Medicaid coverage to include all adults with annual incomes at or below 133% of the federal poverty level, which is currently $14,404 for an individual.

The federal government will pick up the total cost of the expensive expansion for the first three years, after which the funding will phase down to 90%. The expansion could reduce the number of uninsured adults with incomes under 133% of poverty by more than 11 million by 2019, according to a Kaiser Family Foundation estimate.

But here's the catch: The states can opt out of the Medicaid expansion program, since the court said the federal government can't penalize them by withholding all Medicaid funding. Instead, these states wouldn't get the additional Medicaid money to cover newly eligible enrollees. And that could mean trouble for many poor adults who are not eligible for Medicaid under the current system but would have qualified under the expansion. Read more >>