What Health Care Reform Means for the States

Of the 31 million uninsured people who would gain coverage under a revamped health system, about half would do so through a vast expansion of Medicaid - the state-and-federal health care program for the poor. The Senate bill would make eligible anyone earning up to 133% of the federal poverty level (for a family of four, an income of about $29,300 a year); the House bill would lift that threshold to 150% of poverty (or about $33,000 for a family of four). Congress is looking to expand Medicaid because in terms of raw costs, it is the cheapest and most efficient way to cover people of modest means. That's in part because Medicaid pays doctors and hospitals far lower reimbursements than private insurance does and in part because the states pick up some of the cost.