Hi Michelle,
Uninsured individuals in the U.S. have a higher incident rate of being affected by a chronic
condition such as depression or diabetes which could lead to frequent ER visits or extended
hospitalization. In addition, the effects of unmet social needs tend to trickle down the pipe as
providers and health systems struggle to link patients with appropriate resources. For example,
people living in poverty with 4+ unmet needs were less likely to visit a Federally Qualified
Healthcare Center (FQHC) for an annual wellness checkup. Even with the barrier of having to
pay for a visit being taken out of the equation, some families said they did not feel safe
venturing out of their neighborhood for fear of being robbed or killed. (Cole & Nguyen, 2020).
Conversely, the Affordable Care Act is a nightmare for the middle class. My husband works
primarily from home and earns a small income every month. He does not qualify for insurance
through our state Medicaid program because we are married, and I do not meet the income
requirements. If separated, my husband would be eligible for health insurance under the same
program. It makes no sense to break up families so that one can qualify for health insurance.
I searched the healthcare marketplace and found a decent health plan (HMSA-PPO). The cost to
my husband is $800 a month. There is usually a $25 office co-pay, $10 generic drug, and $20 for
name brand. ER, visits have a 20% co-pay along with imaging and laboratory services. When
navigating the marketplace, you put in your income, and the system provides a credit to offset
the plan's cost. In my case, the credit brought down my husband's monthly payment from $800
to $370 a month. At the end of the year, I was given a tax form with instructions to add the
codes from the paper onto my tax return under healthcare cost for marketplace recipients. My
$40 federal refund instantly turned into a $1900 tax bill, mainly because I worked a few hours of
overtime to help pay for the monthly cost of his plan. None of the monthly premium payments
could be claimed on our taxes, only the co-pays. Our healthcare system is broken as it allows
extremely low-income people to qualify for healthcare, but not some of us working-age adults.
BJ
Cole, MB,๎๎Nguyen, KH.๎(2020) ๎Unmet social needs among low-income adults in the United
States: Associations with health care access and quality.๎Health Serv
Res.๎๎2020;๎55:๎873โ๎882.๎https://doi.org/10.1111/1475-6773.13555
