Obamacare: college student falls into gap between Medicaid and exchange plans

My 21-year-old son is currently an unemployed student at Avila University in Kansas City Missouri and has no health coverage.  What are his options?

Studious Parent

 Dear Studious Parent,

I’m guessing from your question that neither parent has a group health plan that would cover him.  That is likely to be the least expensive option.  Assuming that is not available, then he needs to find his own plan.

If he could earn $11,490 (100% of Federal Poverty for a one-person household), then he could qualify for subsidies to buy his own plan from the exchange.  In this case, his insurance would be nearly free.  If he earns less than that, he can’t get the subsidies.  This is due to a quirk in the federal law: the federal law assumed that all states would offer Medicaid to people at the 100% or less Federal Poverty income level.  However, not all states – and Missouri is one of them – are “expanding” Medicaid. Your son is one of the many thousands of people falling into the coverage gap created by states that are not offering Medicaid to all low-income people.  (I am assuming that your son is not disabled or otherwise eligible for Medicaid.)

His university also does not offer a student health insurance plan, but does refer students to an insurer.  This is worth checking out.  It may be less expensive than you think.

If he does end up with no insurance, he would not be charged the penalty tax.  This is small comfort, I realize.

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.