What to do when you don’t qualify for Medicaid coverage but want/need healthcare coverage

I know the PennyHoarder newsletter has a recent article about how many people are losing their Medicaid coverage because of the ending of the pandemic insurance policy, but no where is there any discussion on the reality of why people can’t afford healthcare coverage when the cost of the premiums alone are beyond their ability to pay and still afford all their regular necessities costs like housing. Healthcare coverage premiums are way too expensive to begin with for the average income and it’s time that whoever decides the rates bases the cost on the real average wages earned rather than the assumptions about the wages earned. I didn’t have a decent healthcare plan coverage once the ACA went into effect until I was finally eligible for Medicare which I pay the Medicare premiums subtracted from my Social Security benefits. The premiums decrease my available monthly income plus I have out of pocket costs. My “income “ is barely over the maximum total by a few hundred dollars which means I get no discounts on costs and the burden of paying the out of pocket costs, on top of paying for my necessities bills. What is not mentioned in talking about getting healthcare coverage is the varied premium costs depending on your geographic location which make premiums ridiculously high in areas where there’s a high number of people who get Medicaid coverage for free. It’s the insurance companies who make those who pay premiums make up the costs the insurance companies “lose “ from the coverage given the free Medicaid coverage. I would like to hear from people like myself who don’t get the “free coverage “ and how they avail themselves of the coverage they have. Healthcare coverage should be available for the basic needs of the individual not a coverage plan that offers some coverage plus the cost of service you will never need. I believe that there’s a basic plan on the market that can be implemented as a low cost solution for those who can’t afford the other plans at all which can be offered at extremely low cost ( no more than $10/month) for those who are being removed from the “free Medicaid” programs in coming days . The only problem I see with this, is the assumption that all care is covered. If you make informed decisions about your treatment, most if not all treatment care is covered which should be the way everyone views their medical care.


I’m going to be the devil’s advocate. We passed Obama care, so that the 28 million without health care could be covered. So when I hear that “I can’t afford health care” I have a real issue. Everyone wanted Obama care (except me) and the US government has paid either millions or Billions of dollars for this. I paid for healthcare all my working life, my husband is now covered by Tricare for the military. We paid for that with years of missing events, away from home, wars and everything else. Everyone has the option, once on social security and age 65, to use Medicare. Health care is not a “right” check the constitution. I lived abroad for years in England, with National Health care, and would wait MONTHS to see a provider. So that is not a good solution either.
Sorry for my commentary, but tired of paying for non working programs!

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I agree, we squander billions on those who can work and choose not to and flock to medicaid like they are entitled to it. I have worked steadily for decades and have no medicaid. Health insurance was offered at many levels based on need and what you personally can afford and the company you worked for.
Agreed, millions had it rough with Obamacare trying to fund the program and they found they just could not do it, and then to be fined because they can’t afford to fund it. It just does not work and many did not want it due to really high rates. The solution for those are they did without, which is not good either.
Personally, I would suggest a better job with better benefits. Or a second job.
I resent it when people easily pass off their responsibilities and expect others to step and finance them.
It comes down to one word, choices.

Clearly, there is a difference in views when one calls it “Affordable Care Act” vs “Obamacare.” I don’t feel that the original post was meant to be political.

Maria, my own business pays for health insurance through the Healthcare Marketplace. I have an HMO with a high-deductible health plan so I can qualify for a Health Savings Account. The premium is high and does not cover a lot due to it being a HDHP. I use my HSA to pay out-of-pocket costs and invest what I don’t use.

I also use GoodRx or similar apps to save on prescription medications. I am building my emergency savings account as well.

However, I’m applying for a part-time position at the hospital so I can qualify for better health care benefits. I aim to contribute the maximum to my HSA first.

I probably spend more on healthy eating/nutrition, skincare, home remedies and exercise. All of this can be a struggle, but I’m pushing through!

As a reply to @pinay— You do not have a Medicaid healthcare program based on your description of the coverage you have, especially if there’s a cost of out of pocket expenses passed on to you. What you have/had is what your employer tried to offer you as a required mandate by the ACA/Obamacare rule for employees. Granted not an ideal situation but at least you have access to medical care. Pre-ACA, employers would offer a list of choices of healthcare plans that they would share the expense of the premiums with the employees ( most times they would cover the entire cost as a job benefit ) Again anyone with these kinds of plans don’t qualify for Medicaid insurance because they “earn more than the maximum “. Based on your comment, you are able to afford the out of pocket expenses and whatever premium costs, probably because you have less expenses in the necessities bills—like housing. Many of us don’t/can’t control the housing costs problem if supporting ourselves without someone else bearing that burden, plus can’t afford to only have a part time job to pay all bills while living on their own. But my topic is about finding the different ways those of us who don’t qualify for the Medicaid program can get healthcare coverage and afford the cost while also having to pay regular necessities costs. You have given one example, thanks

I said that I own business but I choose to eventually get a part-time job to help with health insurance. There is no way that one part-time job will pay for my housing and expenses. My business is still growing - meaning lots of marketing, operating expenses, etc. - and until I reach a comfortable and profitable point, I need to supplement my income.

Evidently, I commented on the wrong post since I don’t qualify for Medicaid. I was only sharing how I make things work on my own. Setting money aside, having to pick up another job and yet having almost $0 after expenses/bills is a struggle that many share.