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Comment by wilg | Hacker News Reader

IIRC this gap exists in states (guess which!) that opted out of Medicaid expansion. So a solution is available if states take it.

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To be fair, someone making $25,000 a year will have almost as much trouble paying out of pocket for an MRI as someone making $15,000. But the former won't qualify for Medicaid and the heavily-discounted health insurance won't do much to help with their first $10,000 of medical debt.

Good but worthless advice to the majority living without any savings: don't get sick and don't get injured. Can anyone blame them if they avoid expensive testing? Medicaid is a great bandage, but the US needs a better system.

This is a nationwide problem, it's not restricted to states that opted out of expansion. Federal Law requires that ERs treat anyone who comes in, regardless of ability to pay. Until the poor are able to access other resources like urgent care clinics, this is going to continue to be a problem.

Well the poor have access to Medicaid, and if they make more than the Medicaid maximum, subsidized ACA plans. In neither of those cases should you have to go to the ER for non-emergency care.

I believe the biggest problem is the coverage gap I mentioned, where 10 states for political reasons have not opted into the higher Medicaid maximums which creates a gap between Medicaid and ACA. This is dumb as hell.

I am having trouble figuring out where exactly the other coverage gaps are or how big they are. I'm sure there are some.

I would definitely support a switch to single payer to smooth out this mess.

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