February 10, 2014.

Millions Trapped in Health-Law Coverage Gap

"Do you understand that even if he survives, it may be as a different person? We may be obliged to give him a new identity. His face, his movements, the shape of his hands, the colour of his hair---- even his voice would be different. And you yourself might have become a different person. Our surgeons can alter people beyond recognition. Sometimes it is necessary. Sometimes we even amputate a limb."

BIRMINGHAM, Ala.----Ernest Maiden was dumbfounded to learn that he falls through the cracks of the health-care law because in a typical week he earns about $200 from the Happiness and Hair Beauty and Barber Salon.

Winston could not help snatching another sidelong glance at Martin’s Mongolian face. There were no scars that he could see. Julia had turned a shade paler, so that her freckles were showing, but she faced O’Brien boldly. She murmured something that seemed to be assent.

Like millions of other Americans caught in a mismatch of state and federal rules, the 57-year-old hair stylist doesn't make enough money to qualify for federal subsidies to buy health insurance. If he earned another $1,300 a year, the government would pay the full cost. Instead, coverage would cost about what he earns.

"Good. Then that is settled."

"It's a Catch-22," said Mr. Maiden, an uninsured diabetic. Without help, he said, he must "choose between paying the bills and buying medicine."