Those In The Obamacare ‘Affordability Gap’ Risk Futures In Medical Debt

Meet Karla Castañeda. She’s 22, is a single mother, and recently went back to school. Her son is eligible for Medicaid, but she is not because she makes too much money, and her job doesn’t provide her with insurance. To get coverage, she turned to New Mexico’s insurance marketplace.

“So I looked on the exchange and I signed up and registered and everything and then I started looking to see what plan that I was going to get,” said Castañeda. “I was like ‘there’s no way I’m going to be able to pay this’.”

Castaneda is a community health worker in Albuquerque.

“If I was just a full-time student, of course, I’d probably be able to qualify for Medicaid,” said Castañeda. “But at the same time I wouldn’t be getting any income. So, I have to work, but I still work too much to qualify for Medicaid, so it’s hard.”

Castañeda falls into what’s being called ‘the affordability gap’ — the economic no-man’s-land where you make too much to be eligible for Medicaid and too little to afford coverage on the exchange, even with a federal subsidy.

The Affordable Care Act was designed in part to give more people access to health insurance and could solve a number of problems for low-income people: better access to care, better health outcomes, and a reduction of medical debt. However, there are huge gaps in the plan. And those that fall through the cracks — like Karla Castañeda — run the risk of not having care or running up huge medical bills.

Listen to the story here at the Fronteras Desk.

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Tristan Ahtone

Tristan Ahtone is a member of the Kiowa Tribe and serves as associate editor for tribal affairs at High Country News. He has reported for PBS NewsHour, National Native News, Wyoming Public Radio, NPR, Al Jazeera America, Indian Country Today, and National Geographic, and more. Tristan’s stories have won multiple honors, including investigative awards from Public Radio News Directors Incorporated and the Gannett Foundation. He additionally was awarded a Nieman Fellowship to study at Harvard University in 2017. He is president of the Native American Journalists Association.

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