Bill HaslamNASHVILLE – Republican Gov. Bill Haslam’s refusal so far to expand Medicaid under federal health reform could mean that Tennessee’s poorest residents won’t have access to health coverage in 2014 but some lawful immigrants will, experts say.
That’s because legal immigrants with incomes below 100 percent of the poverty level — $11,170 for a single person or $23,050 for a family of four — will be eligible for federal subsidies to buy private coverage through health insurance exchanges.
American citizens with the same income levels, however, can’t participate in the exchange because the law envisioned those with incomes up to 138 percent of the poverty level would be covered through the Medicaid expansion.
The politically ticklish contrast came about as a result of last year’s U.S. Supreme Court ruling on the 2010 Affordable Care Act.
The act aims to provide coverage to millions of lower-income people in two ways. One is to mandate that most people have health insurance and to help those who can’t afford it by subsidizing purchase of private coverage on new state health insurance exchanges. People with incomes up to 400 percent of the federal poverty level could get subsidies.