In a 5-4 ruling on June 28th, the Supreme Court ruled that the Affordable Care Act (ACA) is constitutional—with one key exception: states must be allowed to decide whether to opt into the Act’s Medicaid expansion.
Traditionally, Medicaid has been available to low-income persons who have children, are pregnant, or have certain disabilities. ACA’s Medicaid expansion would have allowed any individual below 133 percent of the federal poverty level to enroll in the program—bringing health care to 17 million new people by 2016. Unfortunately, because the Court found that expanding Medicaid is optional for states, several governors—including Florida’s Rick Scott and Texas’ Rick Perry—have already said they will not participate, meaning many Americans will still go uninsured.
That means that homeless persons, a majority of whom are uninsured, may not be eligible for benefits under the new law in a number of states. This has severe consequences, as quality health care is vital to homeless persons’ ability to obtain and maintain stable housing.
Critics of the Act argue that the expansion would put a significant burden on already-tight state budgets. But the reality is that the federal government would fund 100 percent of the expansion for the first three years and 90 percent thereafter.
Jeremy Rosen, policy director at the Law Center, remarked that, “while the decision was a win, it was definitely a setback for homeless Americans that states can reject Medicaid expansion.”