Woman Caught In "Medicaid Gap'; Too Poor for Obamacare, Too Rich for Medicaid

OMAHA(KPTM)-She's worked hard her whole life and has been looking forward to signing up for Obamacare. Oksana Kling was hoping the Affordable Care Act would help her afford the insurance she needs to get surgery and keep on working. But when she logged on to the Marketplace, she found out she's too poor to get help paying her premiums.

Kling says she's overcome a lot, from surviving a house fire, to a car accident after which doctors told her she might not walk again, but Kling says she doesn't believe in giving up. Seven years ago, she started a daycare business. But in August of 2013, she was told she needed surgery on her knee. She has been spending her savings since then just to get by.

Kling had been hanging her hopes on Obamacare to pay for that surgery, but when she logged on to the Marketplace, she was shocked to find out that she couldn't afford it. "The deductible (for the silver plan) is just a few dollars short of my gross yearly income, not counting my premium," said Kling who says she makes seven hundred dollars a month.

She says the cost of the premium alone for the Silver plan would cost her almost all of her monthly income. "$23.00 left over each month to pay rent, utilities, groceries, gas, insurance, prescriptions," said Kling who claims when she called the number given to her on the Marketplace, she asked about subsidies she was told she was too poor to get help under Obamacare. "I am told my income is too low, That I am thirty percent of the poverty level, and you have to be at least 140% or higher to qualify for the subsidies that will give you discounts on your insurance," said Kling.

Kling falls into the so-called "Medicaid Gap," where she says she earns too much for regular medicaid, but not enough to qualify for Obamacare subsidies.A study by the Kaiser Family Foundation shows tens of thousands of Nebraskans fall into that gap.

Governor Dave Heineman has opposed expanding Medicaid in the past because he says it's simply too expensive. Heineman has estimated that it would cost about $116 million dollars over the next seven years to expand the program. In the past, Heineman said the expansion of Medicaid could cut finding for childhood education. He also thinks it would result in higher taxes.

Today, Senator Cathy Campbell introduced a bill into the Nebraska Legislature, known as the Wellness In Nebraska Act, which would help provide relief for those unable to get coverage under the current laws.

While lawmakers search for solutions, Kling has designed a "Go Fund Me" page, hoping others will help her pay her pay the bills while she looks for a way to afford health insurance and get the surgery she needs to go back to work.