Health Care Reform by Elizabeth Stawicki, Minnesota Public Radio

May 23, 2012

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ST. PAUL, Minn. The primary goal of the federal health care overhaul is to help provide affordable health insurance to the millions of Americans who lack it. But health planners are wrestling with a little known, yet significant gap in the plan.

A low-income group under age 65 falls into a kind of no-man's land for affordable coverage. They earn too much to qualify for assistance through Medicaid, but not enough to afford even subsidized commercial insurance.

Minnesota officials are considering an optional program to help fill this gap but there is a huge unknown: how much it will cost.

The affordability gap affects about 100,000 low-income Minnesotans, people whose household incomes are slightly above the threshold to qualify for Medicaid's free or low cost coverage.

Yet their incomes are low enough that the deductibles and co-pays of their private health insurance could cause hardship even with the federal health care law's subsidies.

Many individuals in this predicament earn less than $2,000 a month.

According to the non-profit Kaiser Foundation, their out-of-pocket costs for the health care overhaul's benchmark plan could run as high as $220 per month.

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State could help cover federal health care 'no-man's land'