Ernest Maiden was dumbfounded to learn that he falls through the
cracks of the health-care law because in a typical week he earns about
$200 from the Happiness and Hair Beauty and Barber Salon.
Like
millions of other Americans caught in a mismatch of state and federal
rules, the 57-year-old hair stylist doesn't make enough money to qualify
for federal subsidies to buy health insurance. If he earned another
$1,300 a year, the government would pay the full cost. Instead, coverage
would cost about what he earns.
"It's a Catch-22,"
said Mr. Maiden, an uninsured diabetic. Without help, he said, he must
"choose between paying the bills and buying medicine."
The 2010 health law was meant to cover people in Mr. Maiden's income
bracket by expanding Medicaid to workers earning up to the federal
poverty line -- about $11,670 for a single person; more for families.
People earning as much as four times the poverty line -- $46,680 for a
single person -- can receive federal subsidies.
But the
Supreme Court in 2012 struck down the law's requirement that states
expand their Medicaid coverage. Republican elected officials in 24
states, including Alabama, declined the expansion, triggering a coverage gap. Officials said an expansion would add burdensome costs and, in
some cases, leave more people dependent on government.
The
decision created a gap for Mr. Maiden and others at the lowest income
levels who don't qualify for Medicaid coverage under varying state
rules. The upshot is that lower-income people in half the states get no
help, while better-off workers elsewhere can buy insurance with
taxpayer-funded subsidies.
The federal government
offered to pay the full cost of the expansion for three years, and then
states would pay 10 percent of the annual expansion costs. The
Congressional Budget Office estimates the current expansion will cost
the federal government nearly $800 billion over the next 10 years.
Some
GOP-led states are revisiting their decision as complaints pile up over
the coverage gap -- and its consequences for businesses -- in such
states as Utah and Florida. The state senate in New Hampshire last week
reached a tentative deal to expand Medicaid. In Virginia, newly elected
Democratic Gov. Terry McAuliffe hopes to get legislators to reverse his
Republican predecessor's stance against expansion.
Lawmakers
are also getting a push to boost Medicaid rolls from hospitals that
expected a vast new pool of paying customers under the health care law.
Instead, the failure to expand Medicaid coverage by some states not only
adds fewer insured patients, it also eliminates the payments hospitals
had long received to cover the cost of uninsured people they treat free.
***
[so the dems are slowly getting their way? Maiden didn't have coverage before Obamacare. And now he might get it if Alabama (I assume that's the state he lives in) bends.]
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