NCPA - National Center for Policy Analysis

Millions of People Still Unable to Afford Health Care

June 11, 2015

While the Affordable Care Act has succeeded in slicing down the uninsured rate to historic lows, many Americans still cannot afford health coverage and are delaying medical treatment.

Many of these people rely heavily on community health centers — exclusively designed for uninsured people and those with coverage through Medicaid.  The federal government funds the centers on a sliding scale for uninsured low-income people and provides regular Medicaid reimbursements for patients on Medicaid.

Though many expected Obamacare to reduce the number of patients utilizing these community health centers, many of the centers are actually experiencing more patients — especially in states that have not expanded their Medicaid programs.

A recent study by George Washington University found that more than one million low-income, uninsured Americans depend on community health centers. The researchers noted that about 35 percent of those people live in Alabama, Florida, Georgia, Louisiana and Mississippi — states that have not expanded their Medicaid programs.

A 2012 Supreme Court ruling created a "coverage gap" in the 21 states that decided not to expand their programs. People fall into the gap for these reasons:

  • They make too much money to qualify for Medicaid.
  • They cannot afford to purchase even a bronze plan for a large family.
  • They purchased a bronze plan but found the deductibles and co-pays impossibly expensive.

Many of these people turn to community health centers when their options for coverage are limited. Even in states that expanded Medicaid, there are still plenty of people who cannot afford to buy coverage, or can only afford to buy coverage with high out-of-pocket costs.

A recent study from the Commonwealth Fund revealed that about 23 percent of Americans with health coverage — or 31 million ― fall into this category.

Source: Brianna Ehley, "Obamacare Gap Traps Millions with Coverage Who Can't Afford Care," Fiscal Times, June 10, 2015. 


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