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MOUNT PLEASANT — Ken and Gail Ericksen, in their late 50s, have never had health insurance.

Not 30 years ago, when they had their two children; not 20 years ago, when Gail, who is partially deaf, had ear surgery; not five years ago, when Gail went to the emergency room for a broken finger. Not recently, as Ken continues to rebuild their home, which was severely damaged in the record flooding in the summer of 2008.

“We would only go into the doctor if we couldn’t take care of it on our own,” Gail said. “Only if we absolutely had to, we’d go.”

They earn about $18,000 per year, which is equivalent to living at 115 percent of the federal poverty level, yet for what little money they earn they are now too rich to qualify for Medicaid in Wisconsin and too poor to afford the out-of-pocket cost of a plan on the Affordable Care Act’s exchange.

Over the years, the Ericksens paid their medical bills out of pocket when they could afford it; however, payments would lapse and go into collection when they couldn’t make ends meet.

“If we couldn’t afford it, we’d let it go. I like to make sure my bills get paid, but if I can’t, then I can’t,” she said.