Although the Affordable Healthcare Act will help millions who have been without coverage for years, many may find it’s not fool proof! Some may still find they are not eligible for the subsidies, much less Medicaid and be stuck paying way too much for healthcare through their employer. But why might this happen?
For one, those who are working full time hours for a temp agency are ineligible for benefits at the company they work. Also, if they have a spouse who receives health benefits from his or job, that spouse is required to add that person, as well as, any children.
Here’s the kick in the head: the average person doesn’t get paid enough to carry an entire family on their employer’s insurance. So, in this case, in order to override this dilemma, that family household or the spouse has to show proof, the total amount of insurance taken out is at least 9.5 percent of the monthly income.
Basically, not only does the family income have to be between one and four times the federal poverty level, the total insurance payout would have to be 9.5 percent or more to qualify for any government assistance. An example of this: A family of three can’t bring home more than $78, 000 a year.
Myself, like many have done the calculations to estimate our annual income to determine, if we would be eligible to enroll in the healthcare exchange program. Unfortunately, based on the calculations, many seem to be falling into the gray area, once again, for the reasons, I just mentioned earlier.
So how are those Americans supposed to obtain insurance, when the government says they earn too much, and they are unable to receive it from their employer for various reasons, however, if they don’t get it, they are penalized at the end of the year? The supposed expansion on Medicaid, ie., affordable healthcare for everyone doesn’t look like it will work for everyone!
Right now, the cost of insurance through an employer can be costly for the average American and takes a huge percentage of their monthly income. Still if, they are unable to receive help with the new healthcare exchange program, how will coverage have improved? In what way will it have made it better?
And if that’s not bad enough Texas, a state with an estimated 6 million uncovered Americans has elected not to set up its own health insurance exchange. Governor Rick Perry’s assertive letter to the Department of Health and Human Services plainly stated, he finds everything about the healthcare expansion to be an intrusion on people’s rights.
Since, Texas will not participate in any of it willingly, Texans without insurance will have to use the federal exchange, when enrollment starts October 1, 2013. States run by Republicans are more likely to refuse to set up insurance marketplaces than states run by liberal Democrats.
In the case of Texas, the Republican ran legislature, along with the governor are strongly against the federal government getting involved in health care. Perry has made sure there won’t be any expansion of Medicaid in his state either.
Just like other states that have chosen not to participate in that aspect of the PPACA, he believes it to be too costly and an over reach by the United States government. Anyone, hoping for the expansion in Texas, will have to wait until at least 2015 or later when different legislators are in power.
By the way, the tax credit subsidy thing, which plays a major role in all of this, is no different from estimating income tax withholding. If anyone pays too much, than the government will owe that person and vice versa. It’s like playing “The Price Is Right” with that number ("closest without going over") to avoid giving the government a tax free loan. In other words, it's something most are already used to.
Then there is the issue about falling delinquent on premiums. So how does that work, one might ask? As much time as it will take to calculate all the penalties and figure out how to handle the people who get sick, after they are dropped from their carrier, would it, not, make more sense just to force everyone to contribute premiums through tax dollars? Put everyone on the same program according to their last name?
Here’s how it works: When consumers apply for a plan on the health insurance marketplace, also called an exchange, they'll be asked to provide income information to determine whether they're eligible for a premium tax credit. One problem exists at the moment. Health and Human Services admitted they have no way of determining whether an applicant is telling the truth. What’s going on here?
Until 2015, the Affordable Healthcare Act will rely on the honor system—consumers’ self-reported information. Will Americans cheat?