We Finally Have Metro-Level Numbers From States That Refused the Medicaid Expansion, and They're Really Bad

The Affordable Care Act promised a massive expansion of health care coverage for poor, uninsured adults. They would not have to sort through private plan options on the various exchange websites. They would not have to figure out federal subsidies, or find the money to pay for premiums that the subsidies would not cover.

Instead, people making less than 138 percent of the federal poverty line were supposed to qualify for a new and sweeping expansion of Medicaid, the public insurance program for the poor. Nearly half of the states, though, have so far opted not to adopt this part of the law (or take the federal money that comes with it). As I wrote in November, this decision has fallen particularly hard on large urban centers in states like Georgia, Texas, Florida, and Pennsylvania.