Sandra Pico, 52, is pictured outside of her home in North Miami Beach, Fla., Thursday, July 26, 2012. Pico makes about $15,000 a year working about 20 hours a week as a home health aide, a bit too much to qualify for Medicaid, but not enough that she can afford private insurance. She thought she'd be getting health insurance after the Supreme Court upheld the health care law. Then she learned her own governor won't agree to expand Medicaid under the law which would have given her coverage.