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Do you make too little for a subsidy? Some Floridians fall in gap

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Mulrooney family photo Mulrooney family photo
SPRING HILL, FL (WFLA) -  

When the Affordable Care Act's online insurance marketplace launches on Oct. 1, Kimberly Mulrooney could buy insurance for her family of three. But she isn't expected to get a subsidy to help pay for it.

As it turns out, Mulrooney makes too little money to qualify for help.

While her husband studies for a criminal justice degree, Mulrooney works part-time, expecting their income this year to be about $12,000.

When she put that number and others info into a subsidy calculator from the Kaiser Family Foundation, she discovered her family would be expected to pay $6,631 per year for insurance, more than 55 percent of her income.

"This just blows me away," Mulrooney said.

In what may initially seem like a glitch, the couple found that if they made more money - $20,000 – they would qualify for subsidies that would make their premium an estimated $400 per year for the family, which includes their 7-year-old son.

"How weird you have to make more money to get help," Mulrooney said.

The family appears to fall into a gap, making too little to qualify for subsidies to help pay for insurance but sometimes too little to qualify for Medicaid (Mulrooney says as her income fluctuates from month to month, sometimes she is covered by Medicaid but other times she does not qualify).

U.S. Rep. Kathy Castor says the gap is a result of Florida not expanding Medicaid, as had been proposed by the federal government under a scenario that would have come with billions in federal money.

"It's very unfortunate that Florida's going to have to pay the price," Castor said. "It's going to cost us jobs. It's going to cost many of our neighbors access to see a doctor or nurse and get the care they need."

The expansion would extend coverage to up to 274,000 Floridians, Castor's office said.

But given her choice, Mulrooney would rather not be on Medicaid. She says she'd rather buy insurance for her family, if she could afford it.

"If I could get us off of Medicaid, and on our own insurance, I would feel like I'm doing better," she said.

Here’s the calculator the Mulrooneys used to find out how much they would pay:    

http://kff.org/interactive/subsidy-calculator/

 

 
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