Affording the Affordable Care Act

By Michael Ollove
Stateline.org

WASHINGTON. The promise of the Affordable Care Act is right there in its title: “affordable.”

Yet, anti-poverty agencies across the country fear that even with the federal financial assistance available under the law, health insurance will remain unaffordable for significant numbers of low-income Americans.

“For those with very low wages trying to raise kids, after paying for housing, electricity, food, transportation and child care, asking people to pay another $50 or $100 a month, that’s just out of reach,” said Sireesha Manne, a staff attorney at the New Mexico Center on Law and Poverty.

The Affordable Care Act (ACA) is designed to make insurance affordable for Americans with low and moderate incomes, particularly since it requires all Americans to have health insurance starting this year, or face financial penalties.

The law expands Medicaid eligibility (in the states that have agreed to do so) to the poorest Americans, those making up to 133 percent of the federal poverty line.

But it also provides financial assistance for those making up to 400 percent of the poverty level to help them buy private insurance on the new state health exchanges.

Still, the financial help isn’t enough for some.

“Even with the subsidies, some people simply won’t be able to manage to pay their health insurance premiums consistently with all the other costs facing them,” said Janet Varon, executive director of the Northwest Health Law Advocates in Seattle that works on health access issues.

The authors of the ACA anticipated this problem.

To address it, the law allows states to create a separate insurance program, called the Basic Health Program, for people who earn too much to qualify for Medicaid and too little to afford insurance on the state exchanges, even with federal aid.

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