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What Health Care Reform Means For: The Uninsured

Using results from a questionnaire we did with American Public Media’s Public Insight Network, we’re looking at how the proposed health care reforms will actually affect people facing common health care coverage situations. This is the first in a series (Part 2, Part 3).

Anne Johnson, 41

Location: Corona, Calif. Work Status: Unemployed Income: $0

Her story:

Anne Johnson lost coverage for herself and her 18-year-old son in February when she lost her job as a secretary at a solar energy company, where she was earning about $25,000 per year.

Shortly before she was laid off, a cardiologist told her she needs her aortic valve replaced, but without insurance she can’t afford the surgery. She is supposed to get checkups every six months, but that is also too expensive – so she has put them off. Her last visit to the cardiologist was in January, so she is already three months overdue.

"Right now I have no idea what type of condition I'm in," Johnson said.

What health care reform would mean for her:

Johnson’s son may already qualify for Medi-Cal, the state’s Medicaid program, which covers low-income children if they do not have private insurance, because her son is under age 21. (We let Johnson know that her son may be eligible.)

But if she gets a job that pays roughly the same as she earned before but does not provide health insurance, he would most likely lose his Medi-Cal coverage. The House reform plan, and the Senate Finance Committee plan would standardize Medicaid eligibility across states to 133 percent of the federal poverty line, which amounts to $19,378 for a family of two. The plan from the Senate Health, Education, Labor and Pensions Committee (known as the HELP committee) would expand it to 150 percent of the poverty line, still only $21,855.

Johnson would be able to purchase private health insurance from a gateway or exchange, a state-based pool offering a menu of private insurance plans. The House and the Senate HELP bills would also offer her a public plan.

Her low income would qualify her for a subsidy to help buy insurance through the exchange, according to all three reform proposals.

The House plan and the Senate Finance Committee plan would allow Johnson to choose from four levels of coverage ranging from basic to premium, while the Senate Health, Education, Labor and Pensions Committee does not specify levels of coverage.

But if Johnson remains uninsured, she will have to pay a hefty tax penalty: All three plans impose a highly controversial tax penalty on uninsured individuals. The HELP bill would impose a penalty of $750 per year per person, so Johnson would have to pay $1,500. The Senate Finance plan phases in a penalty of $750 per year per uninsured adult, so Johnson would pay the same amount since her son is  18. The House bill would fine families the cost of a basic health insurance plan from the health exchange, up to 2.5 percent of their taxable income.

Critics of the requirement that all individuals have health insurance say it would in effect increase taxes for poor and middle-class people for not being able to afford health insurance.

Anne Johnson shared her story in response to our "How (if at all) has the health care system failed you?" survey. The survey was created in collaboration with American Public Media'sPublic Insight Journalism.

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