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Glitch in Affordable Care Act could leave 500,000 children uninsured

It's being called the "family glitch" and will likely impact those who already have insurance through their employers.

September 24, 2013|by Joanna Small, KSPR News | Reporter

SPRINGFIELD, Mo. -- Experts estimate a half a million children will fall through the cracks of the new healthcare law.  They're saying a "glitch" will leave that many nationwide uninsured.

Let's first look at the numbers: 800,000 Missourians are uninsured.  About half of them have a low enough income to qualify for insurance subsidies on Oct. 1; 300,000 of them will be eligible for Medicaid if Missouri opts to expand the program.  So that takes care of the Missourians falling through the cracks now but this glitch will likely hit those who can already afford insurance -- just barely.

The only thing 2-year-old Grayson hates more than the doctor is haircuts.  But while mom Alisha Ackerman is willing to skip on a snip or two, there's no room for compromise when it come's to her baby's health.  So, when the kitchen chair got the best of Grayson's pinky toe, she took him straight to the walk-in clinic.

"I believe it's $100 to go to the ER, versus $30 at the walk-in clinic and I think it's $50 for urgent care."

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Ackerman has insurance but she's always looking for a deal.

"It's 200 and some odd dollars each pay period and I get paid twice a month," she said. 

She pays nearly $500 a month in premiums and that's after switching off her company's group plan.

"I have a lot of older people that work with me, so it's very high there, so we did individual for just my family and still the rates are high."

At least Grayson is insured; some families aren't so lucky.  The glitch in the healthcare law says those whose employers offer reasonably priced employee-only plans but expensive family plans they can't afford aren't eligible for subsidies in the new marketplace.

"For the most part, this is going to affect individuals and families who have health insurance through their employer right now," said Ryan Barker. 

Barker is part of the Missouri Foundation for Health, which runs the website covermissouri.org.  He says the so-called "family glitch" is one of so many concerns with the Affordable Care Act, but he has an even bigger one.

"It's not just confusion; it's also lack of information.  This summer we did a series of nine focus groups across the state and specifically with folks who were uninsured and, in those groups, very few, I'd say 15 percent, had heard the word 'exchange' and that doesn't mean they understood what it meant."

Ackerman hopes she doesn't have to worry about it.  She's already been told her rates are going up.  She'll stick with her coverage though, whether Grayson likes it or not.

Ackerman has the option to shop for a better plan in the exchange but she won't qualify for a subsidy even though she's paying $6,000 a year in premiums.

If that confuses you, you are not alone.  Check out www.covermissouri.org.  It will tell you -- in the simplest terms -- how to navigate the Affordable Care Act.  There's even a calculator that will help you determine if you can get a subsidy.

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