Georgians Fall Into Insurance Gap

Georgians Fall Into Insurance Gap (Image 1)

Georgia is one of dozens of states that refused to expand Medicaid under the Affordable Care Act. Because of this, hundreds, maybe thousands of people could fall into an income based category that can't afford health insurance, qualify for Medicaid or an insurance subsidy. I asked a local insurance agent how it could affect you.

In January 2014, the Affordable Care Act will take effect. Its promise: health coverage for all. Part of the promise was to expand Medicaid coverage to ensure there were no health coverage gaps.

David Hogan, V.P. of ACHS Insurance explains, “the Health Care reform legislation anticipated all states expanding their Medicaid eligibility to 133% of the Federal poverty level of income.”

But the Supreme Court ruled last year that the Federal Government could not mandate states to expand Medicaid coverage. The result–

“The medicaid expansion has not been adopted by Georgia,” Hogan adds.

He says that anyone who makes more than 50 percent of the of the federal poverty level or, more than $6,000 per individual, will not qualify for Medicaid or insurance subsidies. Creating a confusing coverage lapse.

“Once healthcare reform kicks in Jan.1, 2014 there will be subsidies available for individuals to purchase health insurance at 133% of the Federal poverty level. So you have that gap between 50% and 133%,” Hogan tells us.

If Americans don't have coverage by January 2014 they could be penalized for not having health insurance, but what happens to those making between 6 and 16 thousand dollars a year who don't qualify for Medicaid or a health insurance subsidy?

Hogan believes,”well, they are basically left out in the cold. This is one of the unintended consequences of the healthcare reform legislation.”

The U.S. Census Bureau, 14-point-7 percent of families and 19-point-1 percent of individuals in the state live below the poverty line. Still, Hogan says nearly 15,000 people in Augusta alone will qualify for these subsidies. For more information on the Federal poverty lines or to learn more about the health insurances credits, visit  or

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