More articles on this and such...
Basically, I'm sitting and stressing over whether to switch over to some $150/mo insurance which won't be as good as my current plan but will at least let me keep my doctor, or creatively estimate a higher income that would give me a subsidy (zeroing out my premium) and risk being forced to pay it back if I can't raise my income to match it. In TN for me that's a $1848 gamble... in another state with higher subsidies that might be a higher number.
However what doesn't change from state to state is what's considered poverty level, and I can't help thinking that has a little to do with this issue.
I'm not looking to run a political blog. I like the ideals of the AFA, and I'm glad to see more people get covered. I have many issues with this gap, but I can't blame my state for opting out. A couple of maps and articles to explain why:
Article: Characteristics of Poor Uninsured Adults who Fall into the Coverage Gap
& from Wiki, a map showing Median income in the U.S. by county: http://en.wikipedia.org/wiki/File:US_county_household_median_income_2012.png
While the correlation isn't perfect, basically states with more people who fall into this gap are states with lower median incomes. They've opted out in part because in three years when the Federal subsidies for the new Medicare enrollment go away they would have a much heavier burden on a state system which before had been reserved for people who truly couldn't work because of youth or disability... as opposed to waiting tables so they can take a stab at a music career or some other passion, which doesn't pay off immediately.
The idea that childless working adults can't afford any sort of payment towards coverage is a bit grating, since they fall into a variety of situations. You can probably eek by independently in TN on $10,000 a yr. particularly if you're living outside one of the major cities, even though that's technically below the poverty line, with a room mate or two (or out in the country in a small house handed down through the family), you could juggle a decent living situation. Things here are cheaper than in other parts of the country, and there's a very strong barter/DIY/help your neighbor community going.
Refusing subsidies and trying to force these people onto Medicaid limits their options (and kind of wounds the pride). And many of them sort of hover, dipping above and below depending on the particular year. In Nashville we have very strong arts community...not a stable income generally, but people who are smart with their money know to squirrel away extra in the good years to get through the bad.
Which doesn't mean everyone at or near poverty level is in a great financial situation, but many would rather keep a consistent insurance plan and not worry about having to switch companies and doctors just because their income varied by few thousand here or there. (Note: There's a $1 difference between a full subsidy and no subsidy.) And it's very exasperating to know you could get your premium fully covered if you make $12,000, but since you made $11,000 or $9,000 you're just out of luck.
As this is a Federal level Mandate, then I think the Fed ought to cough off and expand the subsidies to cover the gap they left. And/or reconsider expanding the range of subsidies in lower income states, so the Medicaid burden is more evenly distributed. But for healthy, capable adults, I truly believe subsidies are the better option than Medicaid alone.
Before I get overly grim, part of the reason I took a break from this blog is it's focus is supposed to be those just over the poverty line rather than just under... so while there is a concern over what job loss could mean for those at the edge, full time (childless) minimum wage earners probably do qualify for subsidies. The full-timers who don't are most likely small business owners like me who are trying to build something up with sweat equity.
P.S. There are subsidy gaps on the other end too: http://www.npr.org/blogs/health/2014/03/18/291162837/some-young-people-won-t-get-help-for-affordable-care-act-insurance but most of the young adults I know aren't making this upper end income.
However what doesn't change from state to state is what's considered poverty level, and I can't help thinking that has a little to do with this issue.
I'm not looking to run a political blog. I like the ideals of the AFA, and I'm glad to see more people get covered. I have many issues with this gap, but I can't blame my state for opting out. A couple of maps and articles to explain why:
Article: Characteristics of Poor Uninsured Adults who Fall into the Coverage Gap
& from Wiki, a map showing Median income in the U.S. by county: http://en.wikipedia.org/wiki/File:US_county_household_median_income_2012.png
While the correlation isn't perfect, basically states with more people who fall into this gap are states with lower median incomes. They've opted out in part because in three years when the Federal subsidies for the new Medicare enrollment go away they would have a much heavier burden on a state system which before had been reserved for people who truly couldn't work because of youth or disability... as opposed to waiting tables so they can take a stab at a music career or some other passion, which doesn't pay off immediately.
The idea that childless working adults can't afford any sort of payment towards coverage is a bit grating, since they fall into a variety of situations. You can probably eek by independently in TN on $10,000 a yr. particularly if you're living outside one of the major cities, even though that's technically below the poverty line, with a room mate or two (or out in the country in a small house handed down through the family), you could juggle a decent living situation. Things here are cheaper than in other parts of the country, and there's a very strong barter/DIY/help your neighbor community going.
Refusing subsidies and trying to force these people onto Medicaid limits their options (and kind of wounds the pride). And many of them sort of hover, dipping above and below depending on the particular year. In Nashville we have very strong arts community...not a stable income generally, but people who are smart with their money know to squirrel away extra in the good years to get through the bad.
Which doesn't mean everyone at or near poverty level is in a great financial situation, but many would rather keep a consistent insurance plan and not worry about having to switch companies and doctors just because their income varied by few thousand here or there. (Note: There's a $1 difference between a full subsidy and no subsidy.) And it's very exasperating to know you could get your premium fully covered if you make $12,000, but since you made $11,000 or $9,000 you're just out of luck.
As this is a Federal level Mandate, then I think the Fed ought to cough off and expand the subsidies to cover the gap they left. And/or reconsider expanding the range of subsidies in lower income states, so the Medicaid burden is more evenly distributed. But for healthy, capable adults, I truly believe subsidies are the better option than Medicaid alone.
Before I get overly grim, part of the reason I took a break from this blog is it's focus is supposed to be those just over the poverty line rather than just under... so while there is a concern over what job loss could mean for those at the edge, full time (childless) minimum wage earners probably do qualify for subsidies. The full-timers who don't are most likely small business owners like me who are trying to build something up with sweat equity.
P.S. There are subsidy gaps on the other end too: http://www.npr.org/blogs/health/2014/03/18/291162837/some-young-people-won-t-get-help-for-affordable-care-act-insurance but most of the young adults I know aren't making this upper end income.
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