by Anton Power
The Affordable Care Act was enacted on March 23, 2010 . The reforms will take effect next year. Until that time, many young folks like myself will forgo insurance coverage, sometimes because of the prohibitive cost of coverage, and sometimes because of a perceived notion that we 20-somethings are invincible. Whatever the reason, going without insurance opens us up to unnecessary risk.
While I am not here to argue over the Affordable Care Act, I recognize that it may be in my interest to inform myself and my readers (especially the young ones) about how to search for coverage. Resources are out there, but they are difficult to understand and somewhat intimidating.
So, I asked myself. If I had no insurance, how could I find the most fair and affordable coverage today?
I did a search:
Underneath the Google Ads, the first search result was the federal HealthCare.gov website. I was attracted by the sub-category link, “Free or Low-Cost Care.”
I clicked on the link and was directed to this page:
Medicaid and CHIP
Obviously, Medicaid and CHIP are available for those who need it. But for someone like me who may be fresh out of college and healthy, I don’t think I qualify. However, just for curiosity’s sake, I’ll check it out.
In most states, folks with disabilities who are also on Social Security Income (SSI) automatically qualify for coverage through Medicaid. However, some states also have what the website calls “buy-ins” for disabled folks with higher incomes. Furthermore, what is defined as low income varies with the state. (Very frustrating and convoluted).
If you are a woman who was diagnosed with breast cancer through the Breast and Cervical Prevention and Treatment (BCPT) Medicaid program, you may be eligible for benefits regardless of income level.
If you are pregnant and have income under $20,000 annually, you receive free coverage. Again, this income level may be higher in your state . (This is very relevant for people my age who are often starting families)
CHIP provides free coverage for children in a family of four with income of up to $45,000 .
Community Health Centers
Community Health Centers provide free or near-free primary care to everyone. However, this is obviously not the same as being covered. If a catastrophe occurs when I am uninsured, I may be liable for ALL costs.
Without insurance, using only community health centers, there are a few sparse options in my area for care. First and foremost, the Hill-Burton program  requires 170 hospitals in the nation to provide certain free care.
However, as with anything in our health care system, the program requires a 6-step after-the-fact application (that is unless you anticipate getting hit by a bus beforehand, in which case you are more than welcome to apply ahead of time). This application requires know-how that I feel many may not have the time or resources to navigate:
Finally, the HealthCare.gov website provides a search for private insurance:
If I don’t have care through work, and I can’t first find state or federal programs which fit my need, I am left with purchasing my own private insurance to at least cover myself in case of an emergency.
For a novice insurance customer with no health problems, I am stunned that the first result that comes up in the search has a monthly fee of $154.00. The maximum out of pocket expenses I may be footing annually is $11,900.00. To put things into perspective, a college graduate may not have any savings at all to rely on. This is very expensive for a young person on a budget:
Don’t be fooled to think that this is the cheapest option for an individual plan. After playing around with the sort function at the top, I found a base rate of $124.00 with an out of pocket maximum of $6,000, under the “Estimate Month Base Rate Low-High” option. This is still expensive, but certainly more manageable.
A little digging finds that it is certainly possible for young folks like me to find health coverage that is workable. However, educating oneself on the subject may be difficult when you live on a month-to-month basis. American health care leaves some with many options, but perhaps the options convoluted understanding. Maybe eliminating confusion about health insurance will go a long way to get people in this country safe, healthy, and prepared.
Hippocrates Refusing the Gifts of Artaxerxes I (1792) by Anne Louis Girodet de Roucy-Trioson. Courtesy of: The Lancet
 Affordable care act tax provisions. (2013, April 30). Retrieved from http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions
 Medicaid. (n.d.). Retrieved from http://www.healthcare.gov/using-insurance/low-cost-care/medicaid/index.html
CHIP. (n.d.). Retrieved from http://www.healthcare.gov/using-insurance/low-cost-care/childrens-insurance-program/index.html
Hill-Burton Free and Reduced-Cost Health Care. (n.d.). Retrieved from http://www.hrsa.gov/gethealthcare/affordable/hillburton/index.html