Bridging the Coverage Gap

The U.S. Supreme Court’s ruling on the Affordable Care Act this summer was unexpected in that it made one important provision of the law – the ACA’s new Medicaid program – optional for states.  This means if Nebraska decides not to implement the Medicaid program, it could create a coverage gap that leaves tens of thousands of Nebraskans without any way to access to health insurance, which is the opposite of what the ACA was created to do in the first place.

Check out our visual representation of the coverage gap below, and please feel free to share!

Nebraska has a great opportunity through this new Medicaid program under the Affordable Care Act to improve its health care system and provide health care access for the 225,000 uninsured Nebraskans.  The new program will provide Medicaid coverage to persons under the age of 65 who have incomes below 138 percent of the Federal Poverty Level ($15,415 for a single person and $26,344 per year for a family of 3).  The program is 100 percent federally funded from 2014 through 2016 and then 90 percent federally funded by 2020 going forward.

Currently, Medicaid is only available to income-eligible children (parents making between 100-150 percent FPL, depending on the child’s age), pregnant women (up to 185 percent FPL), the aged, blind and disabled (up to 100 percent FPL), and very poor parents of Medicaid-eligible children (up to approximately 57 percent FPL).

Although the Exchanges will provide premium tax credits and cost sharing subsidies to those making between 100-400 percent of FPL, people making less than 100 percent FPL won’t get any assistance with their health insurance. This creates the gap in coverage that will leave many low-wage workers and working parents without access to affordable health care.

We need the new Medicaid program to bridge that gap so that all Nebraskans can have access to the quality, affordable care they need.

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