The way certain aspects of the Patient Protection and Affordable Care Act are set up, many Americans may be toeing a line between being eligible for Medicaid, and not having to find their own coverage. In states where lawmakers opted not to expand the program, this may be particularly problematic, and experts say it's an issue that needs to be fixed very quickly.
Millions of people with low incomes have long relied on Medicaid benefits to help them obtain low-cost health care when they need it, according to a report from National Public Radio. But Medicaid "churn," as it's called, can be a major issue for those people, because even relatively minor increases in their pay - whether it's from seasonal work or other means of income - could end up having a huge impact on access to that program.
This has always been an issue, but it's exacerbated in some ways by the ACA's coverage requirement, the report said. Now, people who earn too much to qualify for Medicaid may end up being sent to the exchanges, where they likewise might not be able to afford even subsidized coverage because of another, downward, shift in their income.
What's being done?
The ACA is actually intended to help smooth out this problem to some extent, but the fact of the matter is that the exchanges - which are meant to be designed to accommodate both normal subsidized shoppers and Medicaid recipients alike - just aren't capable of handling that issue well yet, the report said. Some individual states have also tried to find their own workarounds for the problem, but those too aren't cure-alls for the issue.
When these problems arise, what usually happens is that recipients end up paying additional premiums for a little while even as they've shifted back to Medicaid, the report said. Experts also note that the Obama administration has already taken some major steps to sort out the problem on its own, but more does need to be done.
Because of the issues people face when they're constantly being shifted back and forth, health insurance agencies may want to try doing a little more to help them work through the problems that arise. That could include offering extremely low-cost policies that will at least cover absolute basics mandated by the ACA, and help people feel reassured in their plans going forward.