Q I’m a single, healthy,
female non-smoker, age 26, living in Tennessee. According to the
HealthCare.gov cost calculator, with a income of only $8,000 a year I
won’t qualify for a subsidy to buy health insurance. How does that make
any financial sense?
But in its 2012 ruling on the constitutionality of the new health care law, the U.S. Supreme Court gave states the option of not expanding Medicaid, and Tennessee was one of the several dozen states that decided against it.
However, the rest of the law was left untouched. Including, unfortunately, the income ranges that determine eligibility for financial help to lower the cost of premiums for private insurance.
Because the original idea was to put all low-income households on
Medicaid, the law confers subsidies only on households with incomes of
between 100% and 400% of the federal poverty level. In states that
aren't expanding Medicaid, this has created a "coverage gap" for people
like you, who make too little to qualify for a subsidy but don’t fall
into a category that’s already eligible for Medicaid. To fix this would
require an act of Congress, which is unlikely given the current state of
Washington politics.
So right now we are stuck with a
two-tier system for the working poor. In states that are expanding
Medicaid, they will enjoy free or nearly free health care. Bailey Comment: "Ain't nothing free". In states
that aren't, they will remain uninsured and unable to get subsidies to
buy private insurance. For a painful contrast you only need to look next
door to Kentucky, which is expanding Medicaid. They've already enrolled
more than 45,000 new people into the program.The sad and frustrating thing is that states can expand Medicaid whenever they want to. What's more, that the federal government is picking up 100% of the cost for the first two years, and 90% after that, so it's a bargain for states. According to this recent report in the New York Times, your governor is trying to get expansion done but the state legislature is balking.
You might want to get in touch with your elected representatives to ask them why they think it's a good idea for low-income working people like yourself to remain uninsured.
Got a question for our health insurance expert? Ask it here; be sure to include the state you live in. And if you can't get enough health insurance news here, follow me on Twitter @NancyMetcalf.
Health reform countdown: We are doing an article a day on the new health care law until Jan. 1, 2014, when it takes full effect. (Read the previous posts in the series.) To get health insurance advice tailored to your situation, use our Health Law Helper, below.