The Affordable Care Act includes a provision to expand Medicaid healthcare coverage to anyone under 138% of the poverty line. However, it is at the discretion of each state to decide to implement the expansion. Judaism teaches that healthcare is one of the key services a community is supposed to provide. Send a letter to your governor and state legislators urging them to implement the expansion.
In its landmark ruling on the Affordable Care Act in June 2012, the US Supreme Court ruled that the expansion of Medicaid to include all individuals up to 138% of the poverty line constituted an unconstitutional “gun to the head” of the States, and therefore could not be mandated. Without the expansion, the only people who could qualify for Medicaid would be low-income families with children and low-income individuals with disabilities. Further, without this expansion, anyone making up to 100% of the poverty line would not even be able to qualify for subsides to purchase health insurance in the exchanges; the most disadvantaged people in the country would be unable to access the healthcare system.
The Supreme Court has left it up to the individual states to decide whether not to implement the expansion. The map below gives a detailed breakdown of where each stands on the expanssion.
States that are on the fence must be encouraged to expand Medicaid and health coverage to those in need. States that have said they will reject the expansions must be urged to change their position.
We learn from ancient Jewish scholars and texts that providing health care is not just an obligation for the patient and the doctor, but for the society as well. It is for this reason that Maimonides lists health care among the ten most important communal services that had to be offered by a city to its residents. (Mishneh Torah, SeferHamadda IV:23). During the long history of the self-governing Jewish community, almost all such communities set up societies to ensure that all their citizens had access to health care. Doctors were required to reduce their rates for poor patients and, where that was not sufficient, communal subsidies were established (Shulchan Aruch, Yoreh Deah 249:16; Responsa Ramat Rahel of Rabbi Eliezer Waldernberg24-25).