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My Experience Applying to ACA in Texas

Open enrollment for obtaining affordable health insurance to take effect in 2015 begins today. Even though I have an undergraduate degree in Biology and an associates degree in a medical field, as well as a reasonable grasp of reading and writing, my attempts to navigate previous versions of ACA enrollment websites proved futile. Knowing that the government website was problematic in the beginning, and being directed to return on November 15, I was eager to get an early start this morning, to review my options, and sign up for affordable health care at the earliest opportunity.

It is not meant to be. If you can conjure in your mind the most egregious exploitation of the poor in exchange for no medical benefit whatsoever, it might just be the Affordable Health Care Act, which is not affordable nor is it health care, at least in Texas. Because I am too poor to qualify for tax credits, and since Texas has declined to expand Medicaid, my entire health insurance coverage can be summed as follows: using an exemption code printed in the Eligibility Notice, I won’t have to pay a fine to the government, in April, at tax time. My eligibility notice states:

You recently submitted an application to the Health Insurance Marketplace. We reviewed your application to see if you can get health coverage through the Marketplace and help paying for coverage and health services.


Based on the information you provided, the new federal health care law provides that you could be eligible for free or low cost health care through Medicaid. However, the state of TX has chosen not to offer you this new health care coverage at this time.

You are not required to pay a penalty for not having health insurance because of your income and because the state of TX declined to expand Medicaid to cover individuals in your situation.

Your household’s yearly income is too low for a tax credit. Generally, individuals and families whose household income for the year is between 100 percent and 400 percent of the federal poverty line for their family size may be eligible for the tax credit.

• You don’t qualify for Medicaid or the Children’s Health Insurance Program (CHIP) in your state.

Since our yearly income is too low for a tax credit, I was anxious to locate an affordable plan, for purchase. I reasoned that there might be coverage available that would be affordable, in case of a catastrophic event, in the least. My husband and I could figure the cost for purchasing the plan into a new monthly budget that we are working on, given our recent move to Texas. After completing my application, the site directed me to an available 33 plans for purchase. Not one plan is affordable. In fact, some of the plans exceed or nearly exceed our monthly income. The lowest-cost plan available calls for nearly half of our monthly income, just for the premium. The deductible is roughly equivalent to one-half of our yearly income. Were I to schedule, for example, a monthly visit to a regular doctor, I would still have to pay cash for every single visit, without even coming close to meeting the deductible. Here is an example, taken directly from the list of choices in my application this morning:

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