1M Uninsured Calif. Residents Ineligible for ACA Subsidies, Medi-Cal
Nearly one million uninsured California residents do not qualify for federal subsidies through Covered California or Medi-Cal because their incomes are too high, according to a review of census data and Affordable Care Act guidelines by the Sacramento Bee (Cadelago/Reese, Sacramento Bee, 3/9).
Medi-Cal is California's Medicaid program.
Under the ACA, individuals with annual incomes below 138% of the federal poverty level -- or about $15,850 -- can qualify for coverage under the Medi-Cal expansion.
Meanwhile, individuals with incomes between 138% and 400% of the federal poverty level can qualify for federal tax subsidies to purchase private coverage through the state insurance exchanges (California Healthline, 2/5).
Details of Subsidy Eligibility in Calif.
The Bee's review found that 240,000 uninsured California residents who do not qualify for a subsidy would be eligible for the financial assistance if they earned $10,000 less annually.
According to the Bee, the findings indicate that hundreds of thousands of state residents actually could save money if their incomes were slightly lower and qualified for the subsidies.
Experts say that expanding subsidies to include residents with incomes four times the federal poverty level could address the problem. However, subsidies for lower-income consumers would have to be pared back to avoid additional costs.
Jamie Court, president of Consumer Watchdog, said insurers should be responsible for lowering rates in order to make coverage affordable for individuals who do not qualify for subsidies. Court said, "Subsidies mask the fact that the rates are too high and people are paying too much."
Covered California spokesperson Anne Gonzales said consumers could work with financial planners or tax experts to become eligible for subsidies. For example, Gonzales said some residents could increase their retirement savings in order to meet income requirements for financial assistance (Sacramento Bee, 3/9).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.