For Uninsured Missouri Reporter, Obamacare Is a Real-Life Story

ProPublica Staff

St. Louis, MO, United States (ProPublica) – by Charles Ornstein

For Missouri public radio reporter Harum Helmy, the Affordable Care Act is more than just a story she covers. It is also a story she’s living.

“I know – an uninsured health reporter,” she wrote to me last month. “The joke’s not lost on me.”

Helmy, 23, a part-time reporter/producer for KBIA in Columbia, Mo., recently completed her coursework at the University of Missouri. She’s on her first professional job. At the station, she covers Obamacare, among other things. But she doesn’t make much money, and if the law worked as it was intended, she would be covered by Missouri’s Medicaid program beginning Jan. 1.

That wasn’t meant to be.

As signed by President Obama, the Affordable Care Act (ACA) would have required every state to expand its Medicaid program for the poor to include adults earning less than 138 percent of the federal poverty level. Those earning more than that, up to four times the poverty level, would qualify for subsidies to purchase health insurance in marketplaces.

But the Supreme Court ruled last year that states could opt out of the Medicaid expansion without consequence, and Missouri along with 24 other states have done just that. The problem is that the law didn’t include subsidies for people in those states who earn less than the federal poverty level to buy coverage through the exchanges – they were supposed to be covered under Medicaid.

That’s the gap in which Helmy sits.

She earns less than the poverty level ($10 an hour for 20 hours per week) and qualifies neither for Medicaid nor a subsidy. Helmy was born in Texas and is a U.S. citizen, though her parents live in Indonesia. While she attended classes at the university, her parents paid for her health coverage.

According to the Kaiser Family Foundation, a nonpartisan think tank, “In states that do not expand Medicaid, nearly 5 million poor uninsured adults have incomes above Medicaid eligibility levels but below poverty and may fall into a ‘coverage gap’ of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits.” In Missouri,’3,000 people, including Helmy, fall into the gap, Kaiser estimates.

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