February issue of Health Affairs estimated that as many as 28 million U.S. adults might "churn" in and out of health insurance programs during the course of a year, sometimes losing coverage more than once.This is just stupid. Why should millions of people have to jump through hoops for insurance coverage? If it weren't for this ridiculous free market idolatry, we could have simply expanded Medicare and called it day. But no, we had to create some Rube Goldberg contraption that complicates an already impossibly byzantine system even more."It's a critical issue," said Cathy Schoen, senior vice president of The Commonwealth Fund, who was not involved with the study. "You could get a raise or lose a week of work or gain a week, and move in and out of coverage."
The problem is a version of the "churning" in and out of Medicaid that has occurred for years, but with some improvements.
Under the traditional Medicaid system, people shifted between having coverage or not having coverage depending on how much they were making.
Under the Affordable Care Act, Americans can move between two programs: Medicaid, which will now be offered to all those whose income does not exceed 133% of the poverty level, and premium subsidies in state-run insurance exchanges, which will be available to people above that dividing line up to 400% of the federal poverty level.
But when their eligibility fluctuates, they're likely to lose coverage at least for a period of time.