ACA Will End Some Unfairness for Low-Income & Disabled

Submitted by John on

It is no secret that there are millions of uninsured citizens living in the United States. The cost of health insurance is unaffordable to most unemployed and self-employed individuals. In fact, the only people likely to have health insurance are those who have very low incomes (in which case the Medicaid steps in) or those who receive health care in the form of employment benefits or the wealthy, who can pay for their own health insurance. The problem is that many disabled individuals lose access to the Medicaid health care benefits they were relying on when they are approved for Social Security Disability benefits. These individuals must suffer a two-year period in which health care is not provided. How does this happen?

In order to receive Medicaid, an individual must meet certain income restrictions. Before an individual is approved for Social Security Disability Insurance payments, they have little to no income and qualifying for Medicaid usually isn’t an issue. However, once these individuals are approved for disability benefits from the Social Security Administration, the amount of their monthly benefit payment often causes them to become ineligible for Medicaid as that monthly disability payment exceeds the income limits that allow a person to remain eligible for this health care program.

To add to the issue, individuals who receive Social Security Disability benefits do not qualify for Medicare benefits until they have been receiving SSDI payments for a total of 24 months. That means 24 months with no insurance to help cover the costs of disability-related expenses. This is a serious concern for individuals who need costly medications and medical services in order to treat their disabling condition.

Fortunately, there is a light on the horizon for the people who are suffering due to this issue. The Affordable Care Act will put an end to this problem in January of 2014, but that day can’t come soon enough. On January of 2014, Medicaid eligibility will be extended to all people who have an income of lower than 138 percent of the federal poverty level income standard. On that day, those people will be entitled to Medicaid benefits and their medical expenses will once again be covered by the Medicaid program. However, that is nearly two years away. What are people supposed to do in the meantime if they don’t have access to Medicaid or any other health insurance program?

Individuals who are suffering a disability and who are not entitled to either Medicare (because they have not been receiving it for 24 months) or Medicaid (because their incomes are too high) may want to contact their local human services agency. Sometimes there are benefits offered at the local level that can help individuals in such situations. If there is no local state-funded health insurance program that can help, individuals may want to look into local low-cost or free medical clinics. These clinics can provide services for free or on a sliding-scale basis, which means you only pay what you can afford for the medical services you need. While these clinics may not be the ideal choice, they are a way to get the medical care you need until January of 2014 arrives.