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America's neediest will suffer in states that reject Medicaid expansion

The real victims of the GOP's Obamacare backlash are America's poorest and most vulnerable citizens, said msnbc's Melissa Harris-Perry and

The real victims of the GOP's Obamacare backlash are America's poorest and most vulnerable citizens, said msnbc's Melissa Harris-Perry and Nicole Lamoureux, executive director of the National Association of Free Clinics. On Thursday's PoliticsNation, they told host Al Sharpton that the country's neediest would be at even greater risk if Republican governors opt out President Obama's Medicaid expansion plan.

Several governors—including those in Florida, Louisiana, Iowa, Mississippi and South Carolina—argue they're concerned soaring healthcare costs could force tax increases or cuts to services, even though the federal government has vowed to cover all the added Medicaid costs in the first three years and 90% after that.

"This expansion will cost the federal government, which is our tax money, and the state a lot of money," Governor Rick Scott (R-FL) told CBS News, explaining his decision. "We can't afford it."

The Affordable Care Act as written previously gave the federal government to withhold all Medicaid money from states that refused to implement the bill's Medicaid expansion. The Supreme Court struck down that provision in late June.

"To opt out of it is to basically say those poor people who live in my state, I mean people who are actually poor, who do not have enough money to afford personal, individual health insurance, will simply go without," said Harris-Perry, "because we're not going to take the overwhelming matching funds from the federal government in order to provide health coverage and health care for our own citizens."

As Sharpton pointed out on the show, the Kaiser Family Foundation reports that states with the highest number of uninsured residents are the ones that are pushing back against the healthcare law. 21% of Florida residents are uninsured, along with 19% in South Carolina and 17% in Louisiana. 

Lamoureux said her patients would bear the brunt of the suffering in states where governors opt not to expand Medicaid. She added that, contrary to popular belief, the majority of those who come to the clinics are employed, with some even working two jobs. 

"The patients coming to free clinics get a bad rap," she said. "Most people think they're living on the dole. Eighty-three percent of our patients come from working households. These are hard-working Americans."

Lamoureux noted that many of those patients must make a choice between providing health care for their child or putting food on the table. She said 2014, when the legislation goes into effect, is too far away for many of her patients.

"This isn't a choice anyone should have to make in this country," she said. "In this country, health care should be a right and not a privilege."

Harris-Perry blasted Republicans for playing politics when children, single mothers and those who may have lost their homes to foreclosure will be disproportionately affected.

"Part of what's appalling is it's going to be the most vulnerable," she said.