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The Health Coverage Chasm (Infographic)

The Health Coverage Chasm (Infographic)

 

Written by Melissa Boteach

The Affordable Care Act will expand health care coverage to millions of Americans. Among other key provisions, it ends discrimination against those with pre-existing conditions, allows young adults to stay on their parents’ plans until age 26, provides subsidies to make coverage more affordable, and expands Medicaid to low-income people who cannot afford insurance.

In ruling on Obamacare’s constitutionality, however, the Supreme Court created a potential coverage gap affecting low-wage workers and other poor adults, who may be left out of the Affordable Care Act’s promise.

While the Supreme Court declared Obamacare constitutional, one part of the ruling struck down the health care law’s penalty for states that choose not to participate in the law’s Medicaid expansion. In short, while the federal government can offer states the “carrot” of increased Medicaid funding to expand coverage to low-income populations, it cannot use the “stick” of taking away existing Medicaid dollars from states that do not want to comply. States can choose whether or not to extend health coverage to low-income people.

Seven Republican governors have already announced their intention to reject the Medicaid expansion, which, if implemented, would give more than 4 million people in those states access to affordable health coverage. Workers below the poverty line in those states, however, are in a double bind: They can’t access coverage through the Medicaid expansion but are ineligible for Obamacare subsidies to help people above the poverty line afford health coverage. This creates a coverage gap for low-wage workers.

To see how this coverage gap would play out, let’s examine the hypothetical situation of a low-wage worker named Jan and her neighbor John, who live in one of these seven states where Republican governors say they will reject the Medicaid expansion.

the coverage gap plays out in a texas suburb

Prior to Obamacare, John was uninsured, as annual premiums for someone his age total about $8,495—approximately one-third of his income. An Obamacare subsidy, however, now provides him with $6,768 per year toward the purchase of health insurance, leaving him with only $143 a month in payments, or 6.91 percent of his income. Under the new health law, John will finally be able to access insurance.

Unfortunately, Texas’s refusal to expand Medicaid creates a coverage gap for workers, similar to Jan, who are living in poverty and thus ineligible for Obamacare subsidies, which ensure that people just above the poverty line do not pay more than 2 percent of their income for health care. The average unsubsidized health insurance premium for a 55-year-old in 2014 is expected to be $8,495—96 percent of Jan’s entire annual salary, and obviously unaffordable for a low-wage worker without some assistance. The U.S. Department of Health and Human Services has announced that people below 133 percent of the poverty line in states that refuse the Medicaid expansion will not be assessed a penalty for not purchasing insurance that is unaffordable to them. But that doesn’t change the fact that Jan will remain uninsured and will have to hope and pray that nothing goes wrong with her health.

States have many good reasons to expand their Medicaid coverage. It will create a healthier workforce, bring jobs into the state by increasing the demand for health care and other goods and services, and provide greater economic security for millions of families. And it’s almost entirely covered by the federal government, which is paying 100 percent of the costs for the first two years and 90 percent of the costs in the long term.

But, as the case of Jan and John proves, it’s also about fairness. States that refuse the expansion are leaving millions of vulnerable families struggling to make ends meet without health care, as their neighbors and friends are able to take advantage of new subsidies and insurance reforms that make gaining access to health care easier. These are often the workers who are cleaning our offices, preparing our food, or caring for our aging parents.

States have a responsibility to ensure that all of their citizens are able to access the promise of affordable health coverage.

This post was originally published by the Center for American Progress.

 

Related Stories:

Romney: If Black People Just Want “Free Stuff” They Should Vote For Obama

Why Republicans Won’t Repeal the Affordable Care Act

Texas Keeps Sticking It To The Poor

 

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28 comments

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12:10AM PST on Dec 19, 2012

Now a days these Info graphics have become viral to spread all kind of information to the people around the globe in a very easy and informative format ! totally love the above information provided and half of the time have been saved in getting the subject !

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Medicare

2:42AM PDT on Sep 16, 2012

Good post, thanks for sharing.

8:28PM PDT on Jul 21, 2012

Sandy, you sure are ignorant. I have been an asthmatic my whole life, since I was a baby. Nothing to do with my lifestyle! My fourteen year old cousin died of cancer last year - and she sure took care of herself, even having an active lifestyle. Many people get sick even when they take care of themselves. And even if they did not, where is your sense of compassion? It's people like you who make me afraid of living in America - people like you who corrode this society and make this a terrible time to live in. Let's hope that you never need medical assistance you cannot afford.

8:57PM PDT on Jul 19, 2012

Fairness is not the Right's way.

8:37PM PDT on Jul 19, 2012

Sandy, not to wish such on anyone but, how about you develop cancer? So you don't smoke, drink, do drugs, etc. Neither do I. Many people who follow the same good lifestyle still get sick. No guarantees sweetheart. What a selfish bitch you are. The way you are blithering I would not be proud to be a fellow American. Somebody better bless America. America needs blessing big time right now. Even calling the US "America" has always indicated to me a supreme arrogance and ignorance. America incorporates dozens of countries, not just the US, but of course those nations are inconsequential to you just are the sick, the elderly, etc. ME, ME, ME! That's your attitude. That's also what's wrong with the world today. You'll never get the Mother Theresa compassionate award will you?

6:01PM PDT on Jul 18, 2012

Of course, it's always those who are covered by health insurance who don't give a rat's you-know-what about anyone else, as long as their butts are covered! Selfish Repugs all! I don't know about the rest of you, but I'm getting tired of footing the bill for strangers when they go to the ER to get treated for the common cold. We need this health care reform bill desperately. Why can't people see that?

5:46PM PDT on Jul 18, 2012

Excuse me for living Sandy E. I am NOT a drunk or a drug addict. My only crime is not making enough money to afford health care. If I lived in another country this would not be a problem but I live in Florida and I am being screwed AGAIN. I had cancer 4 years ago and have not had any testing etc...for 3 years because I lost my job where I DID have insurance. It can happen to anyone at anytime. Have you ever heard the word compassion?

2:33PM PDT on Jul 18, 2012

I take care of myself,I watch what I eat,I walk work love I DO NOT GO TO THE DOCTOR ALL THE TIME. I DO NOT FEEL THAT I NEED TO PAY FOR THOSE WHO DRINK TO DRUNK,DO DRUGS,SIT AND DO NOTHING. WE ARE AMERICANS! WE ARE AMERICANS! IF WE WANT BETTER HEALTH/BETTER HEATH CARE WE DO NOT NEED TO BE TOLD/FORCED TO GET IT. YOU WANT TO BE A SCHLUP? I AM NOT GOING TO PAY FOR YOU CHOICES. WANT BETTER HEATH CARE? MAKE THE MEDICAL COMMUNITY EARN IT! AND GET RID OF THE ILLEGELS! WE HAVE THE RIGHT TO BE SICK AND DYING! WE HAVE THE RIGHT TO NOT SEE THE DOCTOR! WE ARE AMERICANS! GOD BLESS AMERICA!

1:42PM PDT on Jul 18, 2012

Gene J!-- Tons of GREEN stars to you!!! 100% agree with you... Republicans are jackasses!

Adam S- whether or not you are forced, health insurance is not a luxury and you should be "forced" to get it. Subsidies will go a long way in helping those that can't, do!

1:30PM PDT on Jul 18, 2012

if you are not a rich white man, voting for any repugnant is voting against your own interests. Wake up, stay awake, vote these idiots out of office before our entire country goes down the drain.

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