WASHINGTON (AP) — Rejecting the Medicaid expansion in the federal health care law could have unexpected consequences for states in which Republican lawmakers remain steadfastly opposed to what they scorn as "Obamacare."
Rejecting expansion could mean exposing businesses to Internal Revenue Service (IRS) penalties and leaving low-income citizens unable to afford coverage even as legal immigrants get financial aid for their premiums. For the poorest people, expansion rejection could virtually guarantee they remain uninsured and dependent on the emergency room at local hospitals.
Middle-class people who don't have coverage at their jobs will be able to purchase private insurance in new state markets, helped by new federal tax credits. The big push to sign up the uninsured starts this fall, and coverage takes effect Jan. 1.
As originally written, PPACA required states to accept the Medicaid expansion as a condition of staying in the program. Last summer's Supreme Court decision gave each state the right to decide. While that pleased many governors, it also created complications by opening the door to unintended consequences.
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