No, I'm not thinking of Medicaid. I'm talking about an ACA marketplace exchange policy for people with a certain income that qualifies them for not only a subsidy but also cost sharing reductions (CSRs). To get the CSRs, the person has to sign up for a silver plan.
I picked a random zip code in Charlotte, NC (28204) and did the numbers for a 50-year-old female. At an income level of $18,000, she gets a subsidy of $689/month regardless of which plan she chooses on the exchange.
But at $18,000, she also qualifies for CSRs, and can get a Blue Cross silver plan with a premium of $14/month. It has a $250 deductible and an out-of-pocket max of $600. Doctor visits are $5. That's a hell of a deal.
But she may have heard that bronze plans are good for people who don't anticipate needing a lot of coverage. In her case, she can indeed get a bronze plan for a premium $0/month because of the subsidy. But the devil is in the details--because it's not a silver plan, she doesn't get the benefit of CSRs, so the deductible and out-of-pocket max for the bronze plan are $6,750. That illustrates the power of CSRs, and it's something that's not widely known.
And woe betide her if her income is $12,000 and not $18,000. At $12,000, she's at the level that the ACA anticipated would have her covered by Medicaid, so there aren't any provisions for subsidies or CSRs for her. But her state didn't expand Medicaid, so she's SOL. At $18,000 income, she gets great insurance for a manageable price because of a subsidy for her premium and CSRs for her out-of-pocket expenses. At $12,000 income, she gets no help whatsoever, and she'll be paying over $500/month for a plan with a deductible of about $7,000 for a plan on the exchange.
The same general scheme applies for families, but of course the operative income levels are different because you're covering more people, and you'll be dealing with individual and family deductibles and out-of-pocket maximums.
But it all depends on income level, with people with the lowest (but still above Medicaid-level) incomes getting the most help, and in the case of a single person working full time at a minimum wage job, access to very good coverage at a very low price.
That doesn't mean that the dermatological procedures people on this show get would be covered, but the thought that low income people don't take advantage what's available to them in terms of health insurance drives me crazy. I've spent dozens if not hundreds of hours figuring this shit out since Obamacare came into existence, so I don't blame anybody for not understanding it. It's complicated and tricky. But important, so I evangelize.
You may now return to watching gray ribbons of ooze get squeezed out of people's heads.