This segment originally aired Oct. 20, 2016, on VICE News Tonight on HBOA health care coverage gap caused by states that choose to opt out of the Affordable Care Act’s Medicaid expansion has left nearly three million adults without health insurance.“The Supreme Court said that the Medicaid expansion would be voluntary for states, and a number of states have decided not to expand Medicaid,” Larry Levitt of the Kaiser Family Foundation told VICE News correspondent Roberto Ferdman. “Meaning that poor people in those states don’t have access to any help.”Nineteen states have chosen not to expand Medicaid, in part thanks to a GOP-led opposition to President Obama’s signature health care law, even though the federal government covers the cost of Medicaid.“I cannot fathom working much longer in a system where our working poor, the very folks who all this was originally intended to help the most, are completely left out,” Dr. Steve Luking of Reidsville Family Medicine said. “The politicians made a partisan decision, and I think that’s a damn shame.”Read next: Why Texas is the worst state for health insurance in the country