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What a debacle

You mean poor people shouldn't have medical coverage?

I think it's clear that Hawkwin was referring to the fact that the ACA requires fairly solid numbers of individuals choosing to purchase private health insurance in order for the exchange pools to be actuarially sound.

Medicaid expansion was always the largest single pool of folks who would get coverage under the ACA - and people who were already eligible for Medicaid before the ACA were one of the largest pools of the uninsured. But since the government picks up virtually the entire cost of providing health care to Medicaid enrollees, their participation doesn't help support the other working parts of the act, that require healthy non-Medicaid uninsured people to start signing up an paying for insurance.

BTW, that number is probably a bit unduly alarming, because it's going to be skewed a lot by Oregon. Worse than, Oregon's exchange website is completely broken - they haven't been able to enroll a single person through it - but they went out and got about 62K people enrolled for Medicaid outside the exchange process.

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