Archive for September, 2013

Obamacare Has a Glaring Coverage Gap

The idea behind Obamacare is great: get everyone in the United States affordable health insurance. It could have been done better, such as with a single payer system, or even providing a public option, but what was put together was pretty good. There’s a problem though: if your family is below the poverty line, and your state doesn’t participate in Medicaid expansion, you get no subsidy for health insurance, and no Medicaid option if you didn’t already qualify for it. Basically, in this situation, you’re stuck paying full price for health insurance, and nothing changes for you.

Perversely, the people who are poorest and most in need of help from Obamacare will actually be no better off once it goes into effect in states that don’t participate in Medicaid expansion. When I originally voiced concerns about Obamacare, I had expected middle income people to get shafted, but it looks like middle incomes will actually come out more or less ok.

There’s a reason things turned out this way. When the Affordable Care Act was drafted, it was mandatory for all states to expand Medicaid to cover people who were below 138 percent of the poverty line. Subsidies to purchase insurance were then put in place to provide help to people at 100 percent to 400 percent of the poverty line on a sliding scale. Basically, this would have provided assistance to everyone, from those well below the poverty line to those earning a decent chunk of change above it.

Then the Supreme Court intervened. While they upheld most of the ACA, they struck down the portion of the bill that would have required states to expand Medicaid to cover all people below 138%  of the poverty line or lose all federal funding for Medicaid. Leaving the gap in coverage that the poorest of our country now fall into. While it would be sensible to just expand subsidies to them, this would require a new bill amending the law to do so. That seems unlikely to pass, nor is it even really being discussed. People need to be aware of this so it is discussed, and pressure can be put on Congress to fix this issue.

Related Articles on Other Sites:
Missouri’s Poorest Residents Won’t Benefit From Obamacare
Obamacare’s Forgotten Faces

Also, here’s a subsidy calculator you can play with if you want to see what you may qualify for in subsidies. I assume it’s relatively accurate, but can’t make any promises. When you’re done playing with the calculator, or better yet, before you pick it up, spread the word so people know this is happening.

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