What Are Some Policy Options for Reaching
the 2.2 Million Uninsured People in the ACA’s "Coverage Gap"?
A new KFF
issue brief explores several potential policy options that
would help close the Affordable Care Act’s "coverage gap,"
including providing further new incentives for states to expand Medicaid,
creating a new "public option" or extending ACA Marketplace
premium subsidies to low-income people who don’t currently qualify for
federal help.
At stake is affordable
health coverage for 2.2 million uninsured people with incomes below the
federal poverty level ($12,880 annually for an individual in 2021), who
currently do not qualify for either their state’s Medicaid program or
federal premium subsidies in the ACA marketplace. As of April 2021, 12
states have not adopted the ACA’s Medicaid expansion to provide coverage
to adults with incomes through 138% of poverty.
President Biden proposed
the public option approach during the 2020 campaign and is expected to
soon release his American Families Plan proposal that could include a
provision to address the coverage gap.
The KFF brief also
explores the challenges and budgetary cost considerations of the
potential options to expand coverage, all of which are likely to increase
federal spending and could require offsets through other proposals that
produce savings.
A previously released analysis of
the coverage gap is also available.
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