How Health Reform would affect


      Vince: young, uninsured, works part-time

Vince: young, uninsured, works part-time

Vince, 25, waiter and student. Income: $10,000 – too high to be eligible for Medicaid. Too old to be on his parent’s policy.

Under the Proposed Health Reform Bills:

CHOICES

  • Vince could get coverage in a broadened Medicaid program, which will be expanded to include more low-income workers. Currently, Medicaid is reserved mainly for families with children living at or near the poverty level, and is rarely extended to single adults.
  • Or, Vince’s employer might start covering part-time workers. If Vince’s employer doesn’t offer health insurance, the employer may have to contribute to a fund that helps pay for coverage for low-income people like Vince.
  • Vince would have the immediate option of remaining on his parent's health coverage, if his parents have access to private individual or employer coverage.
  • Vince must have coverage unless he can show he can’t afford it.

COST

  • Vince would likely have no, or very small co-pays for medical services, under Medicaid. Premiums will be low or non-existent.
  • Medicaid-eligible persons cannot get premium credits to purchase coverage in the exchange.

DIFFERENCES

House bill (H.R. 3962, passed November 7, 2009):

  • To qualify for Medicaid, individuals can make no more than $16,250 per year. Larger families could have higher income levels and still qualify.
  • Allows young adults to stay on their parents’ coverage through age 26.

Senate bill (H.R. 3590, passed December 24, 2009):

  • To qualify for Medicaid, individuals can make no more than $14,500 per year. Larger families could have higher income levels and still qualify.
  • Allows young adults to stay on their parents’ coverage through age 25.

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