Some six million Americans living in states with expanded Medicaid rolls have so far failed to sign up, even though their incomes qualify them, the Wall Street Journal is reporting.

Another three million are not covered because they live in states that did not expand their Medicaid services under the Affordable Care Act (ACA).

In the states with expanded benefits, to be eligible for Medicaid a person must have an income below 138 percent of the Federal Poverty Level (FPL). In states that did not accept expanded coverage under the ACA, an individual must have income below 100 percent of the FPL.

There is no enrollment period for Medicaid, so some people may wait for a medical necessity to sign up.

In addition, because their incomes are so low, the nine million un-enrolled in Medicaid are not subject to the ACA tax penalty for being uninsured.

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