‘Glitch’ puts low-income families at risk of not having health insurance

By Craig Smith Published: Tuesday, February 5, 2013, 12:01 a.m. Updated: Tuesday, February 5, 2013 A gap in coverage in President Obama's health care overhaul could leave some low-income families without government-mandated health insurance and drive more people to free clinics, officials said.

“I think it would impact many working poor in Pittsburgh,” said Wilford Payne, executive director of Primary Care Health Services, which has 13 locations in Allegheny County and provides health care to the needy. “I think we have a large population that falls in that category.”

IRS regulations issued last week failed to fix what advocates for the needy call the “affordability glitch” in the president's plan. As a result, some families that can't afford the employer coverage that they are offered will not be able to get financial assistance from the government to buy private health insurance on their own. How many people this will affect is unclear.

“That's a major glitch,” said Jay Poliziani, executive director of Northside Common Ministries, where a food pantry provides a week's worth of food to more than 950 people and families each month.

Starting Oct. 1, many middle-class uninsured will be able to sign up for government-subsidized private coverage through new health care marketplaces known as exchanges. Coverage will be effective Jan. 1. Low-income people will be steered to expanded safety-net programs. At the same time, virtually all Americans will be required to carry health insurance, either through an employer, a government program, or by buying their own plan.

Congress said affordable coverage can't cost more than 9.5 percent of family income. People with coverage that the law considers affordable cannot get subsidies to go into the new insurance markets. The purpose of that restriction was to prevent a stampede away from employer coverage. But the affordability calculation does not include coverage for families.

The Obama administration says Congress tied its hands with the way the law was written. Families that can't get coverage because of the glitch will not face a tax penalty for remaining uninsured, the IRS rules said.

“Many of these workers have less job mobility and will be stuck in place,” said Court Gould, executive director of Sustainable Pittsburgh, a public policy group whose mission includes advocating for workers. “Lack of access to affordable health care for the whole family undermines the employee's ability to work to his full potential.”

U.S. Rep. Keith Rothfus, R-Sewickley, said the president's health care law is “riddled with unintended consequences.”

“It does not properly address the problems of cost and access — two areas critically in need of reform,” Rothfus said. “That is why I support repealing the law and implementing carefully thought-out solutions.”

Republicans control the House.

“This could be relatively easy to fix unless congressional Republicans seize on this as another opportunity to score political points at the expense of families getting health care coverage,” said U.S. Rep. Mike Doyle, D-Forest Hills.

About 2 million people, most of them uninsured, visit the nation's 1,200 free clinics each year, according to the National Association of Free and Charitable Clinics in Alexandria, Va.

“Safety net providers like Catholic Charities will see an increase … in the at-risk population,” said Annette Fetchko, administrator of the Catholic Charities Free Health Care Center on Ninth Street, Downtown, which serves the working uninsured and their families — more than 10,000 people in the past five years.

Many families use Northside Common Ministries' food pantry on Brighton Road to offset rising costs of health care, fuel and prescription drugs.

“We have seen a steady demand among the minimally employed,” Poliziani said.

The Associated Press contributed to this report. Craig Smith is a staff writer for Trib Total Media. He can be reached at 412-380-5646 or csmith@tribweb.com.

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