AM 720 KDWN
News, Traffic, Weather

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study. Another study by RAND Corp. shows a larger number of adults gaining coverage.

U.S. Department of Health and Human Services spokeswoman Erin Shields Britt said Monday that the law has brought greater security for millions of Americans but more work remains. In addition to 8 million people who signed up for private insurance through exchanges, Medicaid enrollment has increased by at least 3 million.

“As we look to next year’s open enrollment, we will continue to target outreach efforts to encourage the uninsured to explore their coverage options and enroll in a plan that meets their needs and fits their budget,” Britt said.

For hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, budget is her chief concern. She said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study. Another study by RAND Corp. shows a larger number of adults gaining coverage.

U.S. Department of Health and Human Services spokeswoman Erin Shields Britt said Monday that the law has brought greater security for millions of Americans but more work remains. In addition to 8 million people who signed up for private insurance through exchanges, Medicaid enrollment has increased by at least 3 million.

“As we look to next year’s open enrollment, we will continue to target outreach efforts to encourage the uninsured to explore their coverage options and enroll in a plan that meets their needs and fits their budget,” Britt said.

For hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, budget is her chief concern. She said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study. Another study by RAND Corp. shows a larger number of adults gaining coverage.

U.S. Department of Health and Human Services spokeswoman Erin Shields Britt said Monday that the law has brought greater security for millions of Americans but more work remains. In addition to 8 million people who signed up for private insurance through exchanges, Medicaid enrollment has increased by at least 3 million.

“As we look to next year’s open enrollment, we will continue to target outreach efforts to encourage the uninsured to explore their coverage options and enroll in a plan that meets their needs and fits their budget,” Britt said.

For hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, budget is her chief concern. She said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study. Another study by RAND Corp. shows a larger number of adults gaining coverage.

U.S. Department of Health and Human Services spokeswoman Erin Shields Britt said Monday that the law has brought greater security for millions of Americans but more work remains. In addition to 8 million people who signed up for private insurance through exchanges, Medicaid enrollment has increased by at least 3 million.

“As we look to next year’s open enrollment, we will continue to target outreach efforts to encourage the uninsured to explore their coverage options and enroll in a plan that meets their needs and fits their budget,” Britt said.

For hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, budget is her chief concern. She said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study. Another study by RAND Corp. shows a larger number of adults gaining coverage.

U.S. Department of Health and Human Services spokeswoman Erin Shields Britt said Monday that the law has brought greater security for millions of Americans but more work remains. In addition to 8 million people who signed up for private insurance through exchanges, Medicaid enrollment has increased by at least 3 million.

“As we look to next year’s open enrollment, we will continue to target outreach efforts to encourage the uninsured to explore their coverage options and enroll in a plan that meets their needs and fits their budget,” Britt said.

For hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, budget is her chief concern. She said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study. Another study by RAND Corp. shows a larger number of adults gaining coverage.

U.S. Department of Health and Human Services spokeswoman Erin Shields Britt said Monday that the law has brought greater security for millions of Americans but more work remains. In addition to 8 million people who signed up for private insurance through exchanges, Medicaid enrollment has increased by at least 3 million.

“As we look to next year’s open enrollment, we will continue to target outreach efforts to encourage the uninsured to explore their coverage options and enroll in a plan that meets their needs and fits their budget,” Britt said.

For hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, budget is her chief concern. She said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study. Another study by RAND Corp. shows a larger number of adults gaining coverage.

U.S. Department of Health and Human Services spokeswoman Erin Shields Britt said Monday that the law has brought greater security for millions of Americans but more work remains. In addition to 8 million people who signed up for private insurance through exchanges, Medicaid enrollment has increased by at least 3 million.

“As we look to next year’s open enrollment, we will continue to target outreach efforts to encourage the uninsured to explore their coverage options and enroll in a plan that meets their needs and fits their budget,” Britt said.

For hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, budget is her chief concern. She said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study.

Health advocates say their work isn’t finished. California “has made huge progress with the new benefits of the Affordable Care Act,” said Anthony Wright, executive director of Health Access California. “But there’s more to do.”

Hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials – but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

“We think that most people will get insurance once it’s affordable to them,” said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can’t obtain care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study.

Health advocates say their work isn’t finished. California “has made huge progress with the new benefits of the Affordable Care Act,” said Anthony Wright, executive director of Health Access California. “But there’s more to do.”

Hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. “It doesn’t cover very much. It’s just basic,” she said.

The plan doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

“That affects all our pocketbooks, because we all pay for uncompensated care when people don’t have timely access to preventative care,” Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she’s been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can’t afford a full plan. She earns $1,225 a month and takes her children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a clinic when they need care.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened.

Instead, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

“If I don’t have the money, I just let it go on its own,” Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers continue to prevent millions of people around the nation from accessing care.

Questions of affordability, eligibility, immigrant access and the response from employers and state legislatures – obstacles that existed before the Affordable Care Act took effect – mean considerable work lies ahead.

There are myriad reasons why people remain uncovered. Some are eligible for discounted policies but say they still can’t afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally are blocked from obtaining care under the law. Dozens of states haven’t expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn’t required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it’s not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study.

Health advocates say their work isn’t finished. California “has made huge progress with the new benefits of the Affordable Care Act,” said Anthony Wright, executive director of Health Access California. “But there’s more to do.”

For individuals in need of care, high premiums, co-pays and deductibles present challenges that often can’t be overcome.

Hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, said she couldn’t afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits.

“It doesn’t cover very much. It’s just basic,” she said.

The scant coverage doesn’t qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine for going without insurance until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage under the law. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Another issue is a coverage gap. Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don’t trust the federal government to deliver on its promises and don’t want to be stuck with a program they can’t afford.

Texas is among that group, and Lockett says that’s keeping her shut out.

The Houston woman says she earns too much for Medicaid or a subsidy but can’t afford a full plan. Lockett earns $1,225 a month. She takes her four children – a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son – to the emergency room or a community clinic when the need care.

An asthma attack two months ago cost her $75, which she says is a noticeable chunk of her monthly income.

“I was disappointed,” Lockett said, “because I was kind of excited about getting on the Affordable Care Act on the marketplace.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — The federal health care overhaul is providing coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but many barriers remain.

Questions of affordability, eligibility, immigrant access and the response from employers and state legislatures – obstacles that existed before the Affordable Care Act took effect – mean considerable work remains to make a larger dent in the uninsured population.

Some remain ineligible for Medicaid or government subsidies that lower monthly premiums because their incomes are too high. Others are eligible for the subsidies but say they can’t afford their share of plans sold through government exchanges. Millions of immigrants living in the country illegally are without care, prohibited from gaining coverage under the federal law.

Some employers, meanwhile, have reduced staff hours to avoid a provision of the law that requires health coverage for employees who work 30 hours a week.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives an hour north of Ashville in rural northwestern North Carolina.

During open enrollment, Eliezer’s 6-year-old son was able to qualify for Medicaid, but she continues to go without coverage.

Eliezer works an average of 29 hours a week and isn’t considered a full-time employee. She said she can’t afford the $200 monthly premium and $6,500 deductible in the plan she found on the federal health insurance exchange – even with a premium subsidy. Instead, she pays cash to see her doctor for gastrointestinal pain but can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous insurance coverage, and it’s not yet clear how many previously uninsured people have received coverage.

A Gallup-Healthways Well-Being Index released this month said the share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014. The decline would translate to about 3.5 million people gaining coverage, according to the study.

Health advocates across the nation are keenly aware that their work isn’t finished. California “has made huge progress with the new benefits of the Affordable Care Act,” said executive director of Health Access California Anthony Wright. “But there’s more to do.”

The evolution of the health care law has led to a coverage gap for 4.8 million low-income, childless adults, according to a December survey by Kaiser Family Foundation.

The federal government has offered to pay states nearly all of the costs for expanding Medicaid for those who make up to 138 percent of the federal poverty level, or about $16,000 for an individual, to account for this gap. But since the U.S. Supreme Court ruled that expansion was voluntary, 24 states have opted against it.

High premiums, co-pays and deductibles also remain big hurdles.

Hair salon owner Lola Smith of Palo Alto, Pa., about 100 miles northwest of Philadelphia, said she would have purchased health insurance on the government exchange if it had been more affordable.

Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. But Smith, who becomes eligible for Medicare when she turns 65 next year, was told her plan doesn’t qualify as health insurance under the Affordable Care Act.

“It doesn’t cover very much. It’s just basic, and they told me I would probably have to pay the fine,” she said.

Immigrants also face challenges. The Migration Policy Institute estimated that more than 7.5 million people in the uncovered group are immigrants who are in the country illegally and ineligible for coverage under the federal overhaul. For them, emergency rooms and safety net clinics remain among the few options for coverage.

California had the nation’s highest population of uninsured residents with 5.4 million people who lacked care before the federal overhaul took effect.

Following the recent open enrollment, that number of will drop as low as 3.7 million, according to the University of California at Berkeley’s Center for Labor Research and Education. Of those, almost a million are living in the state without legal permission.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — The federal health care overhaul is providing coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but many barriers remain.

Questions of affordability, eligibility, immigrant access and the response from employers and state legislatures – obstacles that existed before the Affordable Care Act took effect – mean considerable work remains to make a larger dent in the uninsured population.

Some remain ineligible for Medicaid or government subsidies that lower monthly premiums because their incomes are too high. Others are eligible for the subsidies but say they can’t afford their share of plans sold through government exchanges. Millions of immigrants living in the country illegally are without care, prohibited from gaining coverage under the federal law.

Some employers, meanwhile, have reduced staff hours to avoid a provision of the law that requires health coverage for employees who work 30 hours a week.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives an hour north of Ashville in rural northwestern North Carolina.

During open enrollment, Eliezer’s 6-year-old son was able to qualify for Medicaid, but she continues to go without coverage.

Eliezer works an average of 29 hours a week and isn’t considered a full-time employee. She said she can’t afford the $200 monthly premium and $6,500 deductible in the plan she found on the federal health insurance exchange – even with a premium subsidy. Instead, she pays cash to see her doctor for gastrointestinal pain but can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous insurance coverage, and it’s not yet clear how many previously uninsured people have received coverage.

A Gallup-Healthways Well-Being Index released this month said the share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014. The decline would translate to about 3.5 million people gaining coverage, according to the study.

Health advocates across the nation are keenly aware that their work isn’t finished. California “has made huge progress with the new benefits of the Affordable Care Act,” said executive director of Health Access California Anthony Wright. “But there’s more to do.”

The evolution of the health care law has led to a coverage gap for 4.8 million low-income, childless adults, according to a December survey by Kaiser Family Foundation.

The federal government has offered to pay states nearly all of the costs for expanding Medicaid for those who make up to 138 percent of the federal poverty level, or about $16,000 for an individual, to account for this gap. But since the U.S. Supreme Court ruled that expansion was voluntary, 24 states have opted against it.

High premiums, co-pays and deductibles also remain big hurdles.

Hair salon owner Lola Smith of Palo Alto, Pa., about 100 miles northwest of Philadelphia, said she would have purchased health insurance on the government exchange if it had been more affordable.

Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. But Smith, who becomes eligible for Medicare when she turns 65 next year, was told her plan doesn’t qualify as health insurance under the Affordable Care Act.

“It doesn’t cover very much. It’s just basic, and they told me I would probably have to pay the fine,” she said.

Immigrants also face challenges. The Migration Policy Institute estimated that more than 7.5 million people in the uncovered group are immigrants who are in the country illegally and ineligible for coverage under the federal overhaul. For them, emergency rooms and safety net clinics remain among the few options for coverage.

California had the nation’s highest population of uninsured residents with 5.4 million people who lacked care before the federal overhaul took effect.

Following the recent open enrollment, that number of will drop as low as 3.7 million, according to the University of California at Berkeley’s Center for Labor Research and Education. Of those, almost a million are living in the state without legal permission.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.

Affordable Care Act only chips away at a core goal

KDWN

SACRAMENTO, Calif. (AP) — The federal health care overhaul is providing coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but many barriers remain.

Questions of affordability, eligibility, immigrant access and the response from employers and state legislatures – obstacles that existed before the Affordable Care Act took effect – mean considerable work remains to make a larger dent in the uninsured population.

Some remain ineligible for Medicaid or government subsidies that lower monthly premiums because their incomes are too high. Others are eligible for the subsidies but say they can’t afford their share of plans sold through government exchanges. Millions of immigrants living in the country illegally are without care, prohibited from gaining coverage under the federal law.

Some employers, meanwhile, have reduced staff hours to avoid a provision of the law that requires health coverage for employees who work 30 hours a week.

“I’m a nurse, but my employer doesn’t offer health insurance,” said Gwen Eliezer, 32, who lives an hour north of Ashville in rural northwestern North Carolina.

During open enrollment, Eliezer’s 6-year-old son was able to qualify for Medicaid, but she continues to go without coverage.

Eliezer works an average of 29 hours a week and isn’t considered a full-time employee. She said she can’t afford the $200 monthly premium and $6,500 deductible in the plan she found on the federal health insurance exchange – even with a premium subsidy. Instead, she pays cash to see her doctor for gastrointestinal pain but can’t afford to get the problem diagnosed.

“If I went through an emergency room, I can claim acute pain,” she said. “But then I’d end up with a lot of debt to a hospital.”

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous insurance coverage, and it’s not yet clear how many previously uninsured people have received coverage.

A Gallup-Healthways Well-Being Index released this month said the share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014. The decline would translate to about 3.5 million people gaining coverage, according to the study.

Health advocates across the nation are keenly aware that their work isn’t finished. California “has made huge progress with the new benefits of the Affordable Care Act,” said executive director of Health Access California Anthony Wright. “But there’s more to do.”

The evolution of the health care law has led to a coverage gap for 4.8 million low-income, childless adults, according to a December survey by Kaiser Family Foundation.

The federal government has offered to pay states nearly all of the costs for expanding Medicaid for those who make up to 138 percent of the federal poverty level, or about $16,000 for an individual, to account for this gap. But since the U.S. Supreme Court ruled that expansion was voluntary, 24 states have opted against it.

High premiums, co-pays and deductibles also remain big hurdles.

Hair salon owner Lola Smith of Palo Alto, Pa., about 100 miles northwest of Philadelphia, said she would have purchased health insurance on the government exchange if it had been more affordable.

Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. But Smith, who becomes eligible for Medicare when she turns 65 next year, was told her plan doesn’t qualify as health insurance under the Affordable Care Act.

“It doesn’t cover very much. It’s just basic, and they told me I would probably have to pay the fine,” she said.

Immigrants also face challenges. The Migration Policy Institute estimated that more than 7.5 million people in the uncovered group are immigrants who are in the country illegally and ineligible for coverage under the federal overhaul. For them, emergency rooms and safety net clinics remain among the few options for coverage.

California had the nation’s highest population of uninsured residents with 5.4 million people who lacked care before the federal overhaul took effect.

Following the recent open enrollment, that number of will drop as low as 3.7 million, according to the University of California at Berkeley’s Center for Labor Research and Education. Of those, almost a million are living in the state without legal permission.

“When I see there are American citizens who don’t have access to health care because they can’t pay for it, I figure that I’ll have even less of a chance to have access to health services,” said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. “It’s very sad.”

Associated Press writers Marc Levy in Harrisburg, Pa., and Ramit Plushnick-Masti in Houston contributed to this report.