The Exchange told me that my income is too small for subsidies, but Medicaid rejected me. Is there anything I can do?

Often there is. The final rules for the Obamacare Exchange include two little-known provisions that can help many people in this situation. The first deals with people who have a lawfully present foreign citizen in the family. Because it was known that many very low income foreign nationals could not qualify for Medicaid, a means for them to receive very generous Obamacare subsidies was put in place. When the Supreme Court sided with the states that rejected the Medicaid expansion, millions of very low income American citizens fell through the crack, but families with at least one foreigner can take advantage of this provision. The wording of the rule is as follows:

(5) Individuals lawfully present.
If a taxpayer’s household income is less than 100 percent of the Federal poverty line for the taxpayer’s family size and the taxpayer or a member of the taxpayer’s family is an alien lawfully present in the United States, the taxpayer is treated as an applicable taxpayer if—

(i) The lawfully present taxpayer or family member is not eligible for the Medicaid program; and
(ii) The taxpayer would be an applicable taxpayer if the taxpayer’s
household income for the taxable year was between 100 and 400 percent of the Federal poverty line for the taxpayer’s family size.

(From Final rule May 2012)

But what about U.S. citizen? There is actually another means by which very low income people can gain access to subsidies. If a person currently has little or no income but expects that they will finish the tax year with an income over 100% of the Federal Poverty Limit ($11,490), they can receive subsidies based on their expected income. The Obamacare website does not ask what those expectations are based on, but remember that when you sign your application you state that you are answering all questions to the best of your knowledge under the penalty of perjury. So an applicant with an optimistic nature could state truthfully that those are his or her expectations, while the pessimistic applicant could not. (Sorry, Debbie Downer.)

Here is the language from the final rule:

(6) Special rule for taxpayers with household income below 100 percent of the Federal poverty line for the taxable year.
A taxpayer (other than a taxpayer described in paragraph (b)(5) of this section) whose household income for a taxable year is less than 100 percent of the Federal poverty line for the taxpayer’s family size is treated as an applicable taxpayer if—
(i) The taxpayer or a family member enrolls in a qualified health plan
through an Exchange;
(ii) An Exchange estimates at the time of enrollment that the taxpayer’s household income will be between 100 and 400 percent of the Federal poverty line for the taxable year;
(iii) Advance credit payments are authorized and paid for one or more
months during the taxable year; and
(iv) The taxpayer would be an applicable taxpayer if the taxpayer’s
household income for the taxable year was between 100 and 400 percent of the Federal poverty line for the taxpayer’s family size.

(From Final rule May 2012)

However, there is the potential that if the applicant does not finish the year with the expected income, he or she could have to pay back as much as $300 worth of the subsidies (or $600 for a family policy). This is typically a small fraction of the value of the subsidies.