Poorest of the uninsured fall into coverage gap

Written by Matt Paul, Reporter/Producer | Oct 11, 2013 3:47 AM

Kyle Fisher

(Lancaster) -- Pennsylvanians making between 100 and 400 percent of the federal poverty line are eligible for tax credits or other subsidies on the new federal health insurance exchange. But a gap exists for the poorest of the state's uninsured.

An estimated 400,000 Pennsylvanians earn too little to qualify for federal subsidies on the new insurance marketplace, but make too much to qualify for Medicaid.

Kyle Fisher, a staff attorney for the Pennsylvania Health Law Project, says something is wrong with the way the system is operating.

"We're offering exchange subsidies to families with incomes of $60,000, $90,000, middle class, the upper middle class. But to those parents earning under $15,000 or $19,000 a year we're saying, sorry, we have nothing to offer you."

The coverage gap is the result of last year's Supreme Court decision that made Medicaid expansion optional, and Pennsylvania is one of more than 20 states that have so far declined to take part.

Governor Corbett has proposed using federal Medicaid expansion dollars to help Pennsylvanians below 133 percent of the poverty line to purchase insurance on the exchange, along with several other conditions.

Negotiations between the Corbett administration and the federal government are ongoing. In the meantime, anybody living below the poverty line who doesn't qualify for Medicaid is exempt from the individual insurance mandate.


This chart from the Pennsylvania Health Law Project demonstrates the coverage gap.

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