Question of the Week: I cannot afford health insurance
Posted August 24th, 2010 by Christine SebastianQuestion: I cannot afford health insurance. What options are available under health reform and what will it take to qualify?
Health reform makes health care more accessible and affordable for everyone. Here are some of the options for affordable coverage under health reform, along with information about where you can find out if you’re eligible. (Note that many of these options do not take effect until 2014, but new information sources for existing options are available now).
1. Medicaid: You may be eligible for Medicaid depending on your income and family size. Medicaid provides health coverage for low-income children and adults and people with disabilities, and it also provides assistance with health and long-term care expenses for low-income seniors. Currently, Medicaid eligibility varies from state to state. However, beginning in 2014, health reform will expand Medicaid eligibility levels to 133 percent of the federal poverty level, or $29,327 for a family of four (according to the current poverty guidelines). This means that many more people will be eligible for Medicaid.
2. Premium Subsidies: If you don’t qualify for Medicaid, but you still can’t afford coverage, you may be eligible for help with your premium. Starting in 2014, individuals and families earning up to 400 percent of the federal poverty level, or $88,200 for a family of four in 2010, will get help paying their health insurance premiums in the form of tax credit subsidies.
3. Cost-Sharing and Out-of-Pocket Help: In addition to providing help with premiums, health reform also includes ways to make out-of-pocket costs, like deductibles and copayments, more affordable. Beginning in 2014, plans for individuals and small employers will have new caps that limit how much enrollees have to spend each year out of their own pockets to get care. And, individuals and families with lower incomes will be protected with even lower out-of-pocket spending caps. Depending on your income, you or your family may also qualify for additional help paying copayments, co-insurance, and deductibles.
Next Step – Visit HealthCare.gov
To find out about health coverage options available to you both now and in 2014, visit HealthCare.gov. This new web portal will provide you with information about health coverage options in your state, including private insurance, Medicaid, the Children’s Health Insurance Program (CHIP), Medicare, plans for individuals with pre-existing conditions, and coverage for small businesses.
Christine Sebastian is a Health Policy Analyst at Families USA, a nonprofit, nonpartisan organization striving to achieve quality, affordable health coverage for all Americans. For more information, visit www.familiesusa.org.



3 Comments
September 27, 2010 at 1:42 pm by Debra SI don’t see how I can afford my healthcare insurance should the government force me to buy into it. I am a single parent with two boys. One is disable and I am his caregiver. Jobs at this time is hard to come by to say at the least. I feel as if this new law is forcing me into losing everything I own… if I cannot afford the insurance that I am force to get I be force to pay a fine I cannot afford to pay $450.00 in premiums. I might as well as bank it each month and allow it to draw interest til something happens. I am so tired of our government finding ways to legalize extort and fleese us all.
According to the state of tennessee I am over $50(wow I am so wealthy) in combine income to qualified for Tenncare. Its not fair that government politicans get it for free off the backs of taxpayers!!! Who works for who?
[Reply]
Claire McAndrew Reply:
October 22nd, 2010 at 12:17 pm
@Debra S, Debra, the new health care law provides help to people who can’t afford coverage in the ways described above. It does require people who can afford coverage to obtain it, but if you can’t afford coverage, the penalties for not having it do NOT apply to you. This is described in a MomsRising blog I posted this week here: http://www.momsrising.org/blog/health-reform-question-of-the-week-how-will-the-penalties-for-not-having-coverage-be-enforced/. Best to you and your family.
[Reply]
Anita Reply:
October 22nd, 2010 at 12:49 pm
@Claire – thanks so much for sharing your expertise here. We all have questions about the new system– thanks for staying on top of these changes and helping the MomsRising community out!
[Reply]
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