Numerous surveys have found the uninsured rate dropped the most in Medicaid expansion states and among groups of people that had large numbers of uninsured individuals to begin with, such as young adults just starting out in the job market, people of color, people with lower incomes and people living in rural areas, according to the report.
Some groups, however, are still left out, as they have fallen into a coverage gap, meaning they make too little to qualify for for financial assistance to help pay for their insurance premiums under the PPACA, and they make too much to qualify for Medicaid. These groups include:
- Adults with low incomes who aren’t disabled, aren’t parents and live in a non-expansion state. Through its Medicaid expansion provisions, the PPACA required states to cover almost all people under age 65, who are not pregnant, not entitled to Medicare benefits and who have incomes at or below 138 percent of the federal poverty level. However, a 2012 U.S. Supreme Court decision made Medicaid expansion optional for the states. Due to the high court decision, 23 states still haven’t expanded Medicaid.
Since Medicaid was originally required to be expanded in all states under the PPACA, the health reform law didn’t provide for financial assistance for those who fall below the federal poverty level, which is about $11,700 for an individual this year. Therefore, there are approximately 4 million Americans in non-expansion states that make too much to qualify for Medicaid and make too little to qualify for financial assistance under the PPACA.
- Individuals caught in the “family glitch.” Some people can theoretically afford their own coverage, but coverage for the rest of their family is too expensive. Many of the family members aren’t eligible for subsidies in the exchanges due to the way the law is written.
Undocumented immigrants also lack health coverage because although President Barack Obama protected this group of people from deportation with his recent executive action, they are still not eligible to purchase coverage in the health exchanges, and in most cases they’re not eligible for Medicaid.
In addition, there is another group of people who lack health coverage because they don’t want it and,more so, don’t particularly want to be required by the government to buy it. Many people in this group still don’t know they’ll pay a fine next year if they’re not covered, according to the report.
More articles on finance:
8 recent hospital rating and outlook changes, affirmations
5 most-read finance stories: Week of Dec. 1-5
5 hospital CFOs in the headlines this week
