December 9, 2013 9:22 am -

In 25 states where governors have refused to expand Medicaid, many health care consumers are having a difficult time getting coverage.

Navigators are forced to tell more and more people that they probably won’t be able to get covered because their state, all of which had a GOP-controlled legislative chamber or governor, have refused to expand Medicaid. Lynne Thorp, who is overseeing the University of South Florida’s navigator program in that state, told TPM that about one in four people who contact her team fall into that Medicaid gap.

“Those are hardest phone calls because it doesn’t make any sense to them,” Thorp said. “We have to explain that they fall into this gap where this program can’t assist them.”

It makes sense if you look at the numbers. According to the Kaiser Family Foundation, 38 percent of the U.S. uninsured have an income that’s below the poverty line — the population that won’t qualify for either Medicaid expansion or any financial help to purchase private coverage through the law in non-expanding states. About 5 million people fall in that gap in non-expanding states.

But these people probably don’t know that when they walk into a navigator’s office or attend an outreach event. They just want to find out what options are available to them — though it turns out the answer is not many…

Republican officials in Florida and Texas have imposed additional requirements on navigators. Several top GOP senators have begun to disparage navigators in their public comments…

“It’s awful,” one navigator in a non-expanding state said. “It’s basically: ‘Here are the really great options, and you can’t have them.'”