Fredette downplays Mainers in the coverage gap

An op-ed by Rep. Ken Fredette, Maine House GOP Leader states:

Many of the 70,000 people proposed to be put on [MaineCare] with almost no co-pays and no deductibles can instead find private insurance for as little as $4 per week on the Obamacare exchange.

This comment downplays the low-income working people in Maine who won’t have any help with health coverage and will suffer real harms, medical and financial.

Now, some people — those who earn between 100% and 138% of the poverty line — not covered, if MaineCare is not expanded, would get subsides. But numerous others would not.

As Kaiser Health explains in a piece about Maine:

[S]ome adults in Maine fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for premium tax credits. . . People in the coverage gap are ineligible for financial assistance under the ACA, while people with higher incomes are eligible for tax credits to purchase coverage.

Read that again: Numerous low-income working people would have to pay the full premium, thus spending more for coverage than people who earn more than them.

Blocking MaineCare expansion leads to this manifestly unfair outcome.

And these folks are nearly one in five (19%) of the uninsured people in Maine before the ACA. You can see this in the graph (via Kaiser) below, where they are identified as “in the coverage gap.”

Screen Shot 2014-01-06 at 10.46.41 AM

(By the way, the 3% in the chart who are Medicaid-eligible are people who were eligible before the ACA went into effect but didn’t know it.)

There are many Mainers who will be able to get tax credits to buy insurance through the marketplace — 45% of the uninsured. And some will get extensive aid and have little out of pocket expenses. (It sure would be great if Gov. LePage and other Republican leaders would encourage those folks to sign up.)

But Fredette would leave out the nearly 20% of Mainers stuck in the “coverage gap.”

Note: This post has been corrected to note the subsidies available to those with incomes between 100-138% of poverty. The post title was corrected as well. I regret the errors.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.