It is not universal. There is a coverage gap just below the poverty line, between losing eligibility for Medicaid, and becoming eligible for ACA premium subsidies. Just a complete lack of coverage for the people with the greatest need.
(Edit: to be fair, that gap was supposed to be filled by Medicaid expansion, but that largely fell through)
The fundamental reliance on private insurers is the biggest gap in universality. Public healthcare is subject to the private sector’s willingness to permit treatment. With some companies boasting >30% denial rates, that “gap” is a gaping chasm.
What you learned is incomplete: the coverage gap only exists in states that chose not to expand Medicaid coverage, aka those with republican legislatures. As written, the ACA would subsidize an increasing fraction of health insurance cost until someone’s income was a certain level above the poverty line. If their income fell below this level, they would get coverage through Medicaid instead.
Medicaid historically didn’t cover people with incomes this high, so the ACA expanded coverage to higher income residents. The federal government covered 100% of the cost of Medicaid expansion for the first ~decade, and then 90% after that. Several states sued and the supreme court struck down part of the law that required states to go along with this. So they had to opt in to Medicaid expansion. The ones that didn’t (republican state govts) now have a coverage gap.
Its unfortunate because it harms those who needed help the most, but its a consequence of republicans at the state level for refusing expansion, and at republicans at the federal level for refusing to allow any changes to the ACA that would fix the issue.
It is not universal. There is a coverage gap just below the poverty line, between losing eligibility for Medicaid, and becoming eligible for ACA premium subsidies. Just a complete lack of coverage for the people with the greatest need.
(Edit: to be fair, that gap was supposed to be filled by Medicaid expansion, but that largely fell through)
The fundamental reliance on private insurers is the biggest gap in universality. Public healthcare is subject to the private sector’s willingness to permit treatment. With some companies boasting >30% denial rates, that “gap” is a gaping chasm.
Good old “welfare cliff”. It works this way with a lot of low income benefits.
Welp I learn something every day. Thanks for sharing.
What you learned is incomplete: the coverage gap only exists in states that chose not to expand Medicaid coverage, aka those with republican legislatures. As written, the ACA would subsidize an increasing fraction of health insurance cost until someone’s income was a certain level above the poverty line. If their income fell below this level, they would get coverage through Medicaid instead.
Medicaid historically didn’t cover people with incomes this high, so the ACA expanded coverage to higher income residents. The federal government covered 100% of the cost of Medicaid expansion for the first ~decade, and then 90% after that. Several states sued and the supreme court struck down part of the law that required states to go along with this. So they had to opt in to Medicaid expansion. The ones that didn’t (republican state govts) now have a coverage gap.
Its unfortunate because it harms those who needed help the most, but its a consequence of republicans at the state level for refusing expansion, and at republicans at the federal level for refusing to allow any changes to the ACA that would fix the issue.