STEALTH RATIONING: These Patients Are Covered by Obamacare But Can’t Afford Treatment.

Michelle Harris, a 61-year-old retired waitress in northwest Montana, has arthritis in both shoulders. She gets a tax subsidy to help buy coverage under Obamacare, though she still pays $338 a month for the BlueCross BlueShield plan. Yet with its $4,500 deductible, she says she’s doing everything she can to avoid seeing a doctor. Instead, she uses ibuprofen and cold-packs.

“It hurts, but we don’t have that kind of money,” Harris said in an interview. “So I deal with it.”

Harris is one of many people with Obamacare plans that feature high out-of-pocket costs that can put health services out of reach. That’s because the insurance coverage Harris and others like her have purchased is designed not to kick in until patients have spent thousands of dollars.

She’s not alone. While the Affordable Care Act has pushed the uninsured rate in the U.S. near a record low, a Commonwealth Fund study this year found that about four in 10 adults in ACA plans aren’t confident they could afford care if they got sick.

Imagine treating poor and middle-class Americans to Lamborghini subsidies but sticking them with the full price for tuneups.