Healthcare Coverage Gap Essay

This essay examines the issue of healthcare coverage gaps in the United States. It highlights the significant number of uninsured poor adults due to states not expanding Medicaid, creating a coverage gap between Medicaid eligibility and marketplace premium tax credits. Texas is identified as having a disproportionately high number of individuals in this gap. The essay discusses the impact of legislative changes on the working poor, disabled, seniors, and others previously covered under Medicaid. It also analyzes who is over-covered (healthy individuals with FFS plans) and under-covered (26-34 year olds needing preventative care). While acknowledging the US's high life expectancy and low child/infant mortality rates, the essay emphasizes the existing inequalities. Student responses further discuss the healthcare gap, the limitations of the Affordable Care Act in closing the gap, and the challenges of financing expanded Medicaid coverage.

Running head: HEALTHCARE 1
Health Care
Name:
Institution:
Date:

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is there a gap in healthcare coverage?
There are more than 2.5 million uninsured poor adults who fall into this category known as
the coverage gap. This is as a result of the state deciding not to expand Medicaid, this means
that the income of those who fall under this category have an income that is above the
eligibility of Medicaid but below the premium tax credits in the market place.Texas has more
than a quarter of the people in the coverage gap. According to (Schulte, 2013) ,the group that
is most impacted by the recent changes in legislation are the working poor who had been
covered under Medicaid, these are 22 million people that are projected to lose coverage. This
are the most vulnerable and poorest in the country. The other group that will be affected are
the disabled, seniors and others who had qualified even before Obamacare.
Who might be over, and who is under covered?
The people who are over covered are those that are healthy and with FFS plans (Fees For
Service). They pay high premiums so that they can cover the unhealthy people in the same
risk pool. The undercovered are the 26-34 year olds who should be receiving vaccines and
preventative screenings at a bare minimum (The future of the U.S. Department of Veterans
Affairs healthcare in south Louisiana, 2008).
There is evidence of equality of care in our health care system. One of the evidence is that the
U.S has got one of the highest life expectancy rates in the world. The life expectancy rate is
79.3 which is just below Japan with a life expectancy rate at 83 years. Another indicator of
quality healthcare is that we perform very well in terms of child and infant mortality.

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Student 1
I agree with the student because he points out correctly that there is a health gap. He is
correct that nearly 18.5% of people under 65 years were uninsured in 2010. However, I
disagree with him that PPACA has done a lot to close the gap. This is because there is still so
many people who have fallen from the healthcare coverage after the new legislations were
effected. In most cases the Fee for service is old fashioned in many cases (Gruber, 2000).
This model does not bring out the affordability of the healthcare system and rewards over
utilization of healthcare which makes no sense. I agree with the student that the FFS plan is a
fancy reallocation of money and does not improve costs in health care.
student 2
I agree with the second student that there is a gap in the healthcare coverage in the U.S. It is
also true that the rate of uninsured has decreased significantly at a rate of 10% (Miller,
2013). He is also correct to point out that the highest percentage of uninsured is between the
age brackets of 26-34 years. The student suggests that Medicaid expansion may be the
answer if the expansion covers everyone. Money to cover all these people is the main issue
here with regards to where it will come from. This means that some people will have to pay
more to ensure that those who pay less are catered for.

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References
Gruber, J. (2000). Medicaid. Cambridge, Mass: National Bureau of Economic Research.
Miller, J. (2013). Obamacare. Post Hill Press.
Schulte, M. (2013). Healthcare delivery in the U.S.A.. Boca Raton, FL: Taylor &
Francis/CRC Press.
The future of the U.S. Department of Veterans Affairs healthcare in south Louisiana. (2008).
Washington.