Where do America’s Most Uninsured States Stand on the Obamacare Medicaid Expansion?

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One of the ways the Affordable Care Act (the ACA, or Obamacare) insures more Americans is by expanding Medicaid for the very poor. But under the Supreme Court’s June 28, 2012 ruling upholding the ACA, states can opt out of the expansion. Many governors have announced plans to do just that.

In this slideshow, we take a look at the 10 states with the most uninsured residents according to the U.S. Census Bureau. For states that don’t opt out, the expanded program would cover anyone making under $15,400 — or $30,650 for a family of four — starting in 2014. The federal government will pick up 100 percent of the cost for the first three years, with states assuming a portion of the cost starting in 2017 — 5 percent until 2019, and 10 percent thereafter.


Texas Governor Rick Perry speaks during the Texas Republican Convention in Fort Worth in June. (AP Photo/LM Otero)

Texas Governor Rick Perry speaks during the Texas Republican Convention in Fort Worth in June. (AP Photo/LM Otero)

Texas: Opting out
26.3% uninsured

Less than two weeks after the Supreme Court’s decision on the Affordable Care Act, Texas Governor Rick Perry, a Republican, announced that his state would opt out of the Medicaid expansion. “We in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare,” Perry said in a video statement. “I will not be party to socializing health care and bankrupting my state in direct contradiction to our constitution and our founding principles of limited government.” Texas has the highest proportion of uninsured residents in the country, and has four of the top ten most uninsured metro areas in the country.

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