Daily Journal Jackson Bureau
JACKSON – A 20-something person earning up to $25,000 annually living in the Jackson area can purchase the least expensive plan on the health care exchange for $8 per month, or it is $28 monthly for a family of four earning $50,000.
For a person living outside of the Jackson metro area, where these is less competition, the least expensive plan will cost the same individual $75 per month, according to information gleaned from the U.S. Department of Health and Human Services website.
But an individual living in Mississippi earning less than roughly $11,500 annually – or less than 100 percent of the federal poverty level – will not have access to insurance.
A 2011 study by the Center for Mississippi Health Policy estimates that there are more than 170,000 people without health insurance in the state earning less than the federal poverty level.
People over the poverty level – $11,500 for an individual or about $23,500 for a family of four – can purchase health insurance through the exchange that was established through the Patient Protection and Affordable Care Act.
Tuesday marked the first day insurance could be purchased on the exchange.
It has been estimated the Affordable Care Act, called Obamacare by some, would provide health care coverage to an estimated 30 million Americans who previously did not have access. The two primary ways of providing the health care coverage are:
• Through the exchange where people can shop online for a policy that fits their needs.
• Through an expansion of Medicaid to cover people earning up to 138 percent of the federal poverty level – about $15,000 annually for an individual, or about $32,000 for a family of four.
But based on a U.S. Supreme Court ruling, states do not have to participate in the Medicaid expansion portion of the Affordable Care Act.
About half of the states, including Mississippi, have opted not to participate.
Thus, the hole in coverage is left, meaning people and families earning above the poverty level can purchase relatively inexpensive insurance on the exchanges with the aid of federal tax credits.
But people earning below the poverty level do not have the same opportunity because the original intent of the authors of the Affordable Care Act was for people under the poverty level to be covered by the Medicaid expansion.
But when the Supreme Court ruling gave states the authority to opt out of the expansion, Republican Gov. Phil Bryant, a vocal opponent of the law, wasted little time in stating his intention to do so.
“I stand firm in my position that this law is bad for our nation, financially unsustainable and tramples our rights as citizens,” Bryant wrote in his budget narrative in November. “…Personal principles aside, we just cannot afford to expand the Medicaid program.”
For the first three years of the Medicaid expansion, starting in 2014, the federal government will pay 100 percent of the medical costs and, after that, the share paid by the federal government will be stair-stepped down to 90 percent by 2020.
Ed Sivak, executive director of the Mississippi Economic Policy Center, said, “it is a grossly inequitable outcome” to leave people below the poverty level without health insurance.
“It didn’t have to be this way,” Sivak said. “Mississippi’s leadership had the opportunity to expand access to health insurance for the vast majority of the state’s working families and it chose to leave low-wage workers out in the cold.
Now, we have a situation in Mississippi where an individual earning more than $12,000 a year will have access to subsidized health insurance that is affordable while an individual earning less will not.”
The current Medicaid program provides coverage to about 645,000 Mississippians – poor pregnant women, poor children, the disabled and certain segments of the elderly.
For that program, the federal government pays about 73 percent of the health care costs.