A large percentage of Alabama residents fall into an enormous gap in health insurance coverage that leaves many without a place to turn for affordable care.

According to the Montgomery Advertiser, a whopping 139,000 Alabamians fall into a gap that prevents them from receiving health insurance through neither Medicaid nor the Affordable Care Act.

The alarming findings were published in a study by the Kaiser Family Foundation. Alabama ranks third in the country on this list, trailing only Louisiana and Mississippi.

“People in the coverage gap would be eligible for Medicaid should their state opt to expand Medicaid, but are otherwise likely to remain uninsured, as they have limited incomes, are unlikely to have an affordable offer of coverage from an employer, and do not have access to affordable coverage options under the ACA,” the report said.

The Affordable Care Act is one of many legislative endeavors that require organizations to offer appropriate health benefits if they staff 50 or more employees, even if some of those employees only work part-time.

However, in the state of Alabama, those who are not part of such organizations are finding it almost impossible to qualify for their only other option for affordable health insurance, Medicaid.

Adults without children almost never qualify for Medicaid in Alabama. Even if they do have children, Alabamians can only obtain Medicaid benefits if they make 18% or less of the federal poverty line. That equates to an annual income of $2,867 a year for a household of two, and $4,365 a year for a household of four.

The Alabama Medicaid Agency is working to expand these restrictions, making more residents eligible for coverage through the plan. According to the Ledger-Enquirer, legislators in Georgia have already begun to work on expanding their own state Medicaid program to include those who fall into a gap similar to that of Alabama.

Georgia business owners like Dr. Cathy Cook of Cook Dental Care spoke at a recent Medicaid Expansion town hall meeting to remind legislators that expanded health insurance would improve the state’s economy, allowing more people to seek dental and medical services because of their new, affordable insurance plans.

Alabama Governor Robert J. Bentley still has reservations about expanding health insurance coverage because of the costs that the state would incur. He is pushing for a results-oriented system that rewards residents with consistent jobs, as opposed to those who he feels may take advantage of the expansion without earning their insurance.

“The Governor’s position on Medicaid is that the current system needs to be effective and efficient for the people enrolled,” said Jennifer Ardis, a spokeswoman for Bentley. “Under the Governor’s leadership, Alabama has made great strides to transform the current Medicaid system.”

The State Legislature would have to approve any funding or rule changes if and when Bentley decided to accept a proposal for expansion.