Faulty construction of the Affordable Care Act

Some people love Obamacare, some not much, but regardless of your point view, the law has serious flaws. One of them is the so-called coverage gap.

If you earn $X one day, you may receive a substantial tax subsidy toward your premium. If you earn $Y the next day, you may lose your subsidy and your ability to even use the ACA marketplace plans. And by the way, I’m not talking about $Y being more than $X, but less.

If you live in a state that did not expand Medicaid, and your income drops, you may find you are no longer eligible for the coverage you selected through the marketplace and you are also not eligible for Medicaid. You are once again uninsured and now in the “coverage gap”.

Does all that make sense? I hope not because logically it makes no sense at all. Welcome to the wonderful world of Congress, State politics, the White House and the SCOTUS.

6 comments

  1. Your example is a prime example of the flaws in Obamacare. However, it is more basic than that. Any system is fundamentally flawed when it shows consumers their subsidies, and therefore the prices they have to choose from, based on each individual’s _prediction_ of their upcoming income; then retains the ability for the bureaucrats to take back the subsidies if their income prediction turns out to be wrong a year later. Plenty of average Americans are having their “pursuit of happiness” destroyed by this facet of the law.

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  2. Sorry, but all lawfully present in America can enroll in public exchange coverage – even you, despite your medicare coverage.

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    1. I should have made it clear I was referring to getting a subsidy. My example was based on a case where a person was paying $67 a month, lost her job would have been eligible for Medicaid but state didn’t expand so she lost all coverage because she couldn’t afford the full premium. Also, when I was testing the exchange enrollment, based on income it would kick off a child and say they were eligible for CHIPS or kick out an adult saying they are eligible for Medicaid.

      Dick

      Richard D Quinn Quinnscommentary.com

      >

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    2. Jack see the following.

      The Marketplace is not for people with Medicare.
      The Marketplace is for people who are under age 65 and uninsured, underinsured, or looking for more insurance options. If you are aged 65+ and already have Medicare, you are protected from the mandate penalty. Bottom line: You don’t have to do anything. In fact, it’s illegal for someone to sell you a Marketplace plan if you already have Medicare Part A with no premiums and/or Part B. See 5 tips to avoid Open Enrollment scams. – See more at: http://www.ncoa.org/enhance-economic-security/benefits-access/what-the-health-insurance.html#sthash.jlVCU86B.dpuf

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  3. Give it a rest, Quinn. The PPACA is not “perfect”, but millions of Americans are being helped. Five or more presidents before Obama tried to implement affordable healthcare for Americans and they all failed. Democrats are open to improvements, but the Tea Party insists on repeal and let them all die. The immoral Republican state governors who rejected Medicaid expansion for their citizens should be recalled and or sued as in Tennessee. Some days you write rather intelligently and on other days you write like the political terrorist Ted Cruz speaks. This week we saw the laughable idiocy of the terribly disjointed Republican Party. Congressional Republicans gerrymandered their districts so badly that they have to bow to racist and anti-government constituents as radical as the “open carry” “militias” that have moved from Cliven Bundy’s ranch to the Mexican border. These racist bigoted mal-contents are putting guns between the eyes of refugee children and threatening them with death. “America the beautiful”. House Republicans this week demonstrated that situation is fine with them when they failed to act and then left on vacations.
    I applaud the Republicans – preaching: “sue Obama”, “impeach Obama”, “no increase in the minimum wage”, no extended unemployment benefits”, “let the Latino refugee children die”, “out source more jobs overseas through the TPP”, “destroy Medicare”, “privatize (destroy) Social Security”, “no background checks for gun purchases”, “no affordable healthcare for the middle class”, “suppress voting rights for any citizen who may vote Democratic”, Darrell Issa’s idiotic and inane investigations, “destroy American labor unions”, “privatize public schools to benefit the children of only the wealthy”, “reduce income taxes on the very wealthy”, “repeal regulations on the big banks that created the 2008 Bush recession”, “stop regulating big oil and big coal who are polluting out planet and leading us into a future death spiral”, “continue to allow big corporations to enjoy income tax dodges through inversions and many other offshore tax loopholes”, – I could write much more and I will.
    Suffice it to say that these Republican policies will doom them in November. And, I thank them for their stupidity and their ignorance.

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    1. Chill out Wilson you are going to have a heart attack. Stop obsessing over the tea party, they will go away sooner or later. But don’t hold your breath for November. While some of it may be misguided, there really is not a lot of support out there for Obama or his policies despite what the left presents to the public. I’m still looking for a survey or poll that gives him 50% on anything.

      Dick

      Richard D Quinn Quinnscommentary.com

      >

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