What If You Can’t Afford Healthcare?
The New York Times profiles people who earn too little to receive ACA subsidies.
Earlier today I wrote about the bureaucratic hoops I had to jump through to complete my 2017 Affordable Care Act health insurance application:
Everything I Had to Go Through to Get Healthcare for 2017
But what if you jump through all the hoops only to learn that there’s no ACA health insurance applicable to your situation? The New York Times goes in depth on the people health insurance leaves out:
How these dead zones formed is a matter of unanticipated consequences. The A.C.A.’s architects did not predict that the Supreme Court would rule in 2012 that it was up to each state whether to expand Medicaid eligibility, which is how they imagined Americans with the most modest incomes would receive coverage. Even though the federal government would have helped fund the expansion, 19 states opted for ideological reasons not to do so, arguing that they are pushing back against government bloat and the fostering of dependency. A result was that the residents with the lowest incomes in those 19 states were now caught between two nonoptions: They made too much to qualify for Medicaid, or didn’t qualify at all, but they also made too little for publicly subsidized insurance on the exchanges, their income not high enough to trigger the refundable tax credits and cost-sharing that could make the possibility remotely affordable to someone making just a few dollars above the federal poverty level.
In other words: if you don’t earn enough money, you can’t get discounted healthcare through the ACA. You have to pay more for your healthcare than somebody who is considered “low-income,” because your income is too low.
Which is why many people who fall into this so-called “gap” choose to remain uninsured, although the NYT rightly reframes this as “they don’t have access to insurance.”
(I don’t know how much insurance might cost for each of the individuals profiled in the story, but the NYT specifies that some of them are earning around $12,000–$13,000/year, which would mean $1,000 a month before taxes, which would make a health insurance plan that cost even $200 a month—and mine costs nearly $300 for a single person, not counting deductibles and copays—demonstrably unaffordable.)
There are a lot of heartbreaking profiles in the NYT article, but the one that hit me the hardest was the young widow with two children who was caring for her family and putting herself through community college on a $700/month widow’s benefit. She wants to go to nursing school:
One by one, she ticked off her required prerequisites, hunted down transcripts and secured letters of recommendation. She was ready, she thought, to turn in her application to a program in September. But then, while attending an informational meeting, she heard of one last requirement she had not anticipated: Students had to prove they had health insurance.
The cynical part of me wonders if this woman is applying to a quality school, because my educational programs always offered low-cost health insurance to students, and because I know there are a lot of not-super-great “nursing schools” out there:
But then I remember that I went to college and grad school before the ACA allowed people under 26 to stay on their parents’ coverage, so are schools not doing this anymore because they assume many of their students have other options?
Still, I hope there’s another educational option for this woman, because finding another nursing school might be easier than affording healthcare.
Which is not how it should work.
Support The Billfold
The Billfold continues to exist thanks to support from our readers. Help us continue to do our work by making a monthly pledge on Patreon or a one-time-only contribution through PayPal.
Comments