Last June, the U.S. Supreme Court upheld the Affordable Care Act (ACA) but found that the federal government could not mandate state expansion of Medicaid. According to a Feb. 5 article on WHYY, Pennsylvania Gov. Tom Corbett announced that he "cannot recommend," expanding Medicaid in the state. 

Since the ACA's drafters originally assumed that a certain number of poor citizens would be covered by the Medicaid expansion, Corbett's decision may leave single, poor adults uninsured, Professor Robert Field told WHYY.  Particularly "[t]hose who are going to be too rich for Medicaid under the existing formula, but not rich enough for subsidies in the [state health] exchanges," Field said. "It's going to hurt a lot of people who are going to be caught in this never-never world and not be able to afford insurance."

In a previous article on CBS Philly, Field suggested that any decision not to expand Medicaid is politically rooted.  “A lot of Republican governors have political qualms with going along with it,” he said.     

A failure to expand Medicaid, while leaving state citizens uninsured still allows legal immigrants to be insured through federal insurance subsidies, Field added.  Therefore, such a decision might generate political backlash, Field added. 

Field is a nationally recognized expert on health care policy and health law. He recently moderated a panel with other experts in the field of public health on the post-election fate of the ACA.