After the Affordable Care Act first rolled out in 2012, Americans were put on edge about the concept of being forced to obtain and maintain health insurance. The idea of facing tax penalties was outrageous, but was designed to ensure everyone strives to purchase coverage for themselves and their families. Under Obamacare, there are also options for health insurance for American students studying abroad. While the idea is genuine, it doesn’t account for much for those who are struggling to make ends meet, but aren’t qualified for Medicaid or Medicare. This is known as the coverage gap.
What is the Coverage Gap?
This accounts for the adult population that is currently living in poverty, but don’t qualify for Medicaid because their state didn’t expand it. Then tie in the fact that the income of these families is too low to get subsidized comprehensive coverage from the Obamacare marketplace.
What Happens to Individuals in the Coverage Gap?
The unfortunate individuals that end up in the health insurance Twilight Zone are stuck in a limbo where they are unable to get the health care they need. There are people in this gap who are living with health conditions that require medical attention, but go without treatment because of this problem.
The Issue with Short-Term Health Insurance
One option people are going towards is short-term health insurance, since it is cheaper. However, it doesn’t qualify under Obamacare, so those with these plans still end up facing tax penalties. Plus, these policies won’t provide coverage for per-existing health conditions. The out of pocket costs for these temporary plans can also be very high.
Alternatives for Coverage Gap Victims
There are other ways these individuals can get the health care they need when ACA-compliant coverage is out of their budget range. Here are a few solutions these individuals can consider:
- Move to a state that has expanded Medicaid. This may be difficult for people in the gap because their incomes are too low, but a transfer to a branch in another state could be an option.
- Try getting a higher-paying job or apply for a second job to raise your income to the federal poverty level. This too will be problematic for most, who have likely already tried this option.
- Buy a non-ACA compliant plan that provides the benefits needed and just pay the tax penalty. Just note that these aren’t designed to be stand-alone coverage.
- Go to free clinics and health centers funded by the federal government, which provide primary and preventive care services.
- Go to the emergency room if you absolutely need to, since they cannot turn you away, even if you don’t have health insurance. They must stabilize your condition, but aren’t required to provide ongoing treatment.
The real solution to this problem would be for every state to expand Medicaid. This would allow those who can’t afford ACA-compliant coverage to get the health care they need. This is a concern that will only grow more dire as children with Medicaid grow into adults and also become ineligible or unable to afford Obamacare health insurance plans.