Ive tried to apply to medicaid twice this year(2015) and both times, they have denied me. But when I try to find health insurance on the Obama Marketplace site, the private insurances block me out because they think my income is too low.

so I feel locked out of having health insurance.

I work an hourly job with tips, so my income ebbs and flows. this also makes it really hard to fill out applications, where they assume you make the same amount, down to the dollar, every check.

I just don't know what to do.

  • 3
    Why does medicaid deny you? You're locked out from ACA marketplace only if you're qualified for medicaid, if you're not qualified - you should be able to get a policy at the exchange (you might need to find the checkbox to check).
    – littleadv
    Dec 14, 2015 at 5:20
  • 1
    You should be able to contact someone who will help you with the enrollment process. Look around your state/federal exchange website for info. (For instance, the California exchange has a page here with info on how to find someone who can help you.)
    – BrenBarn
    Dec 14, 2015 at 6:58
  • "the private insurances block me out because they think my income is too low." You should be able to use the Marketplace no matter how low your income is (even if it's so low that you qualify for Medicaid) -- you just wouldn't be able to get a subsidy.
    – user102008
    Jul 3, 2016 at 7:47

1 Answer 1


I assume that you live in a state that did not expand Medicaid coverage, and you're in the so-called "Medicaid gap"? In that case, this is the answer from healthcare.gov:

You can get care at a nearby community health center. The health care law has expanded funding to community health centers, which provide primary care for millions of Americans. These centers provide services on a sliding scale based on your income.


You also state that you have a job and that your income is not constant, which is causing your trouble on applications. A couple of points on that:

  • If you work sufficient number of hours, your employer is obliged to provide healthcare coverage at a "reasonable" (as defined by the law) cost.
  • You stated trouble completing forms requiring income because of the fluctuations that you experience. Usually some type of averaged value is appropriate to report in these cases. I definitely would not let that hold your back from applying for anything. It's not that unusual to have an income that varies throughout the year in a wide range of occupations from waiter, to farmer, to lawyer, to small business owner.

To the extent that you are blocked (legally or practically) from getting coverage, you will also want to take note of this, from the same page linked above, to avoid paying a penalty on top of not having coverage:

[If you don’t qualify for either Medicaid or Marketplace savings:] If you don’t have any coverage, you don’t have to pay the fee. Under the law, most people must have health coverage or pay a fee. But you won’t have to pay this fee if you live in a state that hasn’t expanded Medicaid and you would have qualified if it had. This is called having an exemption from the fee. You can get an exemption when you apply for coverage in the Marketplace. Or you can apply for the exemption without having to fill out a Marketplace application.

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