Some simple changes to improve ACA (Part One)

Here are some simple “fixes” that would reduce confusion over ACA provisions, help further the individual goals of the statute, and possibly improve the efficiency of signing up ACA customers, and the reason why they are needed.

1) Eliminate the Medicaid gap for non-expansion states: The ACA provides that  taxpayer units (individual or joint followers) are eligible for premium assistance tax credits when household income is between 100-400% of the federal poverty line. At the time of drafting, it was assumed that all any person with income under 100% of the FPL would be enrolled in Medicaid, as the terms of the original statute essentially mandated expansion in all states. (States which did not agree to expansion would have faced loss of federal funds).

However, after the US Supreme Court struck down the Medicaid provisions, half of US states opted out, meaning that individuals who earn less than the FPL who live in those states are not eligible for subsidies on the exchanges.  This leaves many of the neediest individuals out in the cold, and undermines the central goal of ACA: to provide insurance for all.

The ACA still doesn’t exist in North Carolina

In this state, you have only two options if you want an ACA-compliant health insurance policy: Blue Cross/Blue Shield (“BCBS”) and Coventry.

Correction: If you live in one of the 39 counties that Coventry covers you have two options. In the other 61 counties in N.C., you have only one option: BCBS.

But you can’t get a subsidy through BCBS because their website can’t connect to healthcare.gov, and I’ve been told you can’t even get a quote from Coventry. I’ve heard that some people have managed to set up an account at healthcare.gov but I’m not one of the lucky few, and I’ve tried maybe 20 times by now.