Health insurance churn expected

Pills on money symbolizes costs of U.S. health care

TEXT OF STORY

JEREMY HOBSON: Well yesterday Senate Democrats blocked a Republican attempt to repeal the new health care law. But a report out today from the journal Health Affairs finds a new wrinkle in the law. Since your income will determine if you qualify for Medicaid or subsidies to buy insurance through state exchanges, what happens when your incomes fluctuates?

Here's Marketplace's Nancy Marshall Genzer.


NANCY MARSHALL GENZER: What will happen is people will ping-pong between Medicaid and the state insurance exchanges every time their income changes. The study included 20,000 people. It found half would experience income fluctuations that would change their eligibility -- repeatedly.

Harvard physician Benjamin Sommers co-authored the study.

BENJAMIN SOMMERS: The frequency of those changes may be so frustrating that an individual may just decide, I'm not going to keep doing this for what can be inconsistent coverage over time.

So they would remain uninsured. Sommers has a solution: Guarantee Medicaid or subsidized insurance for, say, a year regardless of income changes.

Georgetown health policy analyst Judy Feder has another idea: Let people's income fluctuate within a certain range.

JUDY FEDER: If their income goes up by a certain percentage or dollar amount, that nobody's going to care, that's OK.

But these solutions might take new legislation.

In Washington, I'm Nancy Marshall Genzer for Marketplace.

About the author

Nancy Marshall-Genzer is a senior reporter for Marketplace based in Washington, D.C. covering daily news.

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