Well, for me Obamacare is a washout.

[Brigid]

Went to a sign up event today and came away with nothing. Nada. Zip. El zilcho. Niente. Rien. You get the idea. I'm glad for those who are getting help. But for the rest of us, it's a big fat zero.

Let me be clear: I don't blame Obama. He simply joins the many presidents (almost all of them since TR, I believe) who tried and couldn't do it. He had more success than most. I do not blame the navigators -- there is nothing to work with in this state. It's a country that just does not value its citizens. Someday it will be costly. It already is, considering that we have the most expensive health care "system" with some of the worst outcomes

[Sarah Ibarruri]

1. What happened? And are you in Illinois? nt

[CaliforniaPeggy]

2. What happened?

What kind of trouble did you have?

[Rex]

3. None of the plans were worth it?

Or just couldn't get the help you needed?

[Skittles]

4. Too many details, Brigid

[steve2470]

24. I c wut u did their

(and yes I know how to speak English quite well, thank you kindly )

[JaneyVee]

5. Depending on where you are, I heard they are

Being overwhelmed with requests due to coming deadline. Crazy that states still haven't fully addressed this issue yet.

[Rex]

7. You can be sure Red States are doing everything they can to throw

a monkey wrench into the mix. I cannot WAIT for Dick Perry to get his ass outta my state! It will be fun to watch him fail again in 2016.

[JaneyVee]

9. Seriously! And they call themselves "pro-life".

[Cal33]

141. You are right. The corporations are doing everything they can possibly think of--

both legal and criminal -- to destroy whatever Obama is trying to accomplish
for our nation.

I have never seen a more cunning, evil and destructive group of people in all
my days. Instead of evolving into something better, these people are
retrogressing to an earlier, more vicious and primitive type of humans that we
had taken so long and so painfully grown out of.

[upaloopa]

6. Hard to get anything from your post.

If you have ins already are you keeping it.
Are you in a state without expanded Medicaid? What?
I won't believe you without more information.

[Brigid]

10. Believe me or don't.

I'm in IN and the navigators simply don't have much to work with. No medicaid expansion, no exchange, nothing. I hope the people I saw there with kids did better.

[stevenleser]

13. You've given us nothing to believe. Virtually everyone who has complained on DU who actually gave

specifics has been helped by other DUers with getting what they need or has been proven to not be telling the truth.

If you are making less than $12K/yr as an individual, or whatever the cut off is for states that didn't do the medicaid expansion, you are permitted to claim you expect to make at least 12K. That will put you into the exchanges at the maximum level of subsidy getting you a bronze plan for free at the low end or a platinum for around $90 a month at the high end.

Again, I am guessing because you havent given us anything in the way of specifics. So its not a matter of us believing you. You haven't given us anything to believe.

[Brigid]

15. Then why didn't the navigators do anything with that?

I never knew that.

[stevenleser]

16. They usually don't. They're not trained to think that way.

The Obama administration came out with a ruling that said if you overstate your income, there will be no punishment or penalty. The only time you will get "in trouble" is if you understate your income to get an additional subsidy.

If you go back and tell them you expect your income will be over $12,500 this year, you should get everything you need.

[Fumesucker]

25. For some of us estimating an income over $12,500 is not remotely plausible

For instance the long term unemployed can have incomes of zero.

Evidently lying about one's income on official documents is now Democratic policy.

[lumberjack_jeff]

144. If your income is zero, you're eligible for medicaid everywhere.

The median state medicaid cutoff, among those states that didn't expand medicare, is 47%. So if you made 50% of fpl in 2013 ($5485), the administration is saying that estimating $11680 for 2014 is permissible.

That margin for error is about as closely as I can estimate my next years income anyway.

[progree]

52. "The only time you will get "in trouble" is if you understate your income to get an additional

subsidy".

Really, I haven't heard that one before. I put a lot of thought and care when I estimated my 2014 income, but now I think I will probably exceed it considerably by $10,000 to $20,000. Precisely exactly what section of the law or executive order or whatever spells out the punishment?

[stevenleser]

55. Depends on the circumstances. This spells it out to some extent...

http://www.hsaforamerica.com/hsablog/income-estimates-aca-subsidies/

Essentially, if the mistake was understandable, i.e. your income is variable like yours seems to be, no problem. The problems come into play if there is an intent to defraud by lowering your income.

[progree]

57. Thx for quick answer at 117 am! But I don't see any punishment, just that I have to pay it all back

in the worst case. Which is only fair. And it looks like one doesn't even have to pay it all back:

If you receive a subsidy overpayment, the amount you have to pay back will be capped with a limit based on your income level. For example, if you were overpaid for your subsidy amount due to incorrect income estimates, and your income is at 200 percent of the federal poverty level, the cap on the subsidy amount you have to repay is only $600. . If it falls between 200 and 300 percent, the cap is $1,500; etc. etc. More: http://www.hsaforamerica.com/hsablog/income-estimates-aca-subsidies/

Anyway, my tax person said they aren't going to screw people at least in the first year of the program for misundersetimating (thanks G.W. Bush for that word). I don't see how they could expect anyone to project their income an entire year or more in advance.

Even estimated tax payments ask one to pay in taxes based on one's PRIOR 3 month's income. E.g. 1st quarter 2014 estimated taxes is due April 15, 2014, after one has already been through the first 3 months of the year so one knows their 1st 3 months of income.

[dsc]

71. what happens to your other government benefits if you do that

My sister lives in a state which did expand Medicaid but if it hadn't she would be in the position of telling food stamps and the utility help she gets that she has virtually no income but telling health care that she expects to make 12500.

[stevenleser]

73. You are asking for expert advice on state programs where you havent even named the state.

First off, outside of ACA, state programs are generally based off of what you are earning now. Not a pie in the sky estimate of what you hope to have earned once all is said and done at the end of the year.

You could probably tell the food stamp folks and the administrators of whatever other program that you put $12K down hoping that at some point in the middle of the year, you would get a good job.

Obviously, each person has to determine what the potential impacts will be and get advice from expert people in their state what the impact of anything might be to their situation.

[dsc]

74. I am not the one telling people to say this

you are and that was my point, though admittedly it was inartfully expressed. Neither of us have any idea what this person in IN is doing in regards to other benefits but to blithely tell them to dishonestly state an estimate of their income on a government document seems rather irresponsible for exactly the reason you state in your post here.

[stevenleser]

76. Be honest. Your real motivation is you lament the loss of the talking point against the ACA.

Your concern might seem more genuine if you weren't such a raging critic of the ACA all along.

The Obama admin has put out a statement on this basically encouraging people to do this by saying there will not be any penalty for it.

yes, what you wrote was inartful, and for more than the reasons you acknowledged.

[dsc]

77. No it isn't

In point of fact, my sister is a direct beneficiary of the act, but I do think to blithely tell people go ahead and lie about your income when you quite likely are getting government benefits is foolhardy at best and dangerous at worst. I supported the act over and over again, to be blunt stop lying about my record. If you can find one, just one, post of mine where I have argued against this act post it now or shut up about what I posted.

[stevenleser]

78. Your attempt at melodrama isn't working when the POTUS and his administration said it was fine to

do so.

And no, it is not a lie. No one knows for sure what their income will be. Anyone can be fired or laid-off tomorrow and anyone can get a great job offer a day/week/month/quarter from now. It's a guess and yes it can be an extremely hopeful one as the Obama administration themselves indicated.

Again, whatever you keep trying to push, you have an ulterior motive for not wanting people to be able to get healthcare who are in those states where medicaid wasn't expanded. Whether or not I guessed exactly right what that ulterior motive is, you have one.

[dsc]

123. It is fine from the perspective of the feds

but do you really think that say Rick Scott or Pat McCrorry or Rick Perry to name three won't be using this as an excuse to cut people off of food stamps or at least make life very difficult for them. What I don't want is for people to take your foolish advice and have a state take away their food stamps WHICH EVEN YOU ADMIT YOU DON'T KNOW IF IT WOULD OR WOULDN'T HAPPEN. Are you going to restore them if it happens? Will you be taking them out to dinner if it happens? It is nothing short of foolish for a government beneficiary to over state their income of a form without know the consequences for doing so. You admit you have no earthly idea what the consequences would be, neither do I. The difference is you are advocating them doing do while I am not. I think they should at least ask their local food stamp or welfare office just what would happen.

[VanillaRhapsody]

109. did you write this OP?

[dsc]

124. No I wrote the post he responded to

do you ever read posts you respond to or is this a particularly bad thread for you in this regard. Twice you have quite obviously not bothered to read posts to which you have responded.

[VanillaRhapsody]

126. Well you DO seem to be speaking for them....

THAT was the point that went right over your head.....

[dsc]

132. No I am not speaking for the person

who I presume to be capable of speaking for themselves. I do think that it is important to point out that the advice being given is at least somewhat risky.

[VanillaRhapsody]

133. but what that person said IS true....

you do the ACA on estimated projected income for the year...if you underestimate you will pay the difference.

the state programs are based on what you are actually making at the moment...

Those are both in fact.... facts.

[dsc]

134. again I agree the feds likely won't punish you for over estimation

even if that over estimation gives you benefits you otherwise weren't entitled to, but I certainly think it is valid to wonder what governors of places such as LA, TX, WI, IN, NC and FL among others, will do when the feds say a person said they would be making x dollars while the state has them making y dollars. I certainly wouldn't put it past them to make the beneficiary justify their incomes again and again to stay on the program at the very least. I think that at least merits a discussion and not a total dismissal and accusation of an ulterior motive. I have seen first hand just how much paper work is involved in keeping eligibility for these programs without having the problem of overstating one's income on federal forms.

[VanillaRhapsody]

135. Like I said...it won't ....the Feds WILL know what you made for the year....with next years taxes...

if you underestimated....you will pay back the difference.

What is so hard to understand about that?

[dsc]

136. you trust the likes of rick scott and rick perry a hell of a lot more than I do

I can certainly see them and a whole lot of other governors demanding recipients go through lengthy and difficult recertification processes using the estimated income as a justification, if for no other reason than to keep their programs cheap. I think anytime you overstate your income, and this is about over stating income, not understating it, you are running a risk of having the state try to kick you off programs. The underestimating is an entirely different kettle of fish and would only affect the feds. The advice people were giving the poster, incase you didn't bother to read it, was to OVERSTATE their income so they would qualify for the subsidies (their current income puts them in the category that was supposed to get Medicaid and thus not need subsidies). It is that OVERSTATEMENT, that concerns me.

[VanillaRhapsody]

137. dafuck???

[dsc]

138. I guess you really don't read posts

this entire subthread, the whole entire thing, is about a poster saying that he OP should overstate their income on the form to qualify for subsidies. If you didn't know that then you clearly just plain don't read posts before you respond and that is just plain sad.

[VanillaRhapsody]

139. I did read it....

it will all become a wash when you pay taxes next year....if you underestimated it you pay it back....simple as that....this is a projection of what you are going to make in the future...how did you expect it to work?

[dsc]

140. I am going to try this one more time very very slowly

This isn't about people who say they are going to make less money it is about people who say they are making more money (to get out of the Medicaid part so they can get subsidies). Those people are most probably on other income based benefits (such as food stamps, grants for school, etc). Those people are now telling one level of government (the feds) that they are intending to make more money that the qualifying level for the state programs they are on. Do I know the state will make their lives miserable for doing this, no? Do you know they won't? No. That is my point. You and Steve are telling people to do this without having any idea at all if it will put them in jeopardy or not and these people live in states that clearly have contempt for the poor.

[VanillaRhapsody]

142. How about doing some research before saying so....Kaiser seems to agree with us...

see here:

http://www.kaiserhealthnews.org/Stories/2013/August/12/income-projections-low-income-Obamacare-state-medicaid-marketplace-exchange.aspx

While there are steep fines for knowingly lying on a government application for financial assistance, if someone merely miscalculates their income above the poverty level in 2014, and is later found to have made less than the poverty level, they won't have to pay any money back, according to the Treasury Department.

"There's little risk because under the rules you don't have to pay anything back," said Richard Trembowicz, vice president for Celtic Insurance Co., a subsidiary of Centene Corp. which is offering plans on several exchanges, including Mississippi.

[dsc]

143. I am glad you have finally read what I wrote, at least in part

but you are still leaving part out. I have never said, because I don't believe, that the feds will go after those who overstate their income to get the subsidy. What I have said, because I do believe, is that it is possible that some governors (hint those run states) will go after those within their states who over state their incomes. I have no idea if they will or if they won't but neither do you which is my point.

[progree]

148. "I am glad you have finally read what I wrote, at least in part"

I'm not only glad, I am astonished. At long last (well, again in part). I don't know why VR keeps dodging and ducking the issue that public assistance agencies might (and do) compare information, and then thinking people aren't noticing that VR is responding to every point EXCEPT the one you are making. Over and over again.

I haven't seen anything that says what someone puts on their application for ACA subsidies or Medicare is not shared with other agencies.

An interesting Google search: welfare information sharing detecting fraud

[VanillaRhapsody]

154. THIS is an ESTIMATE of income....it is about your income in the future....as long as

you are actively trying to make that amount...THEN it won't raise a flag...ESPECIALLY if you are in a non-compliant state.

NOW YOU read the Kaiser link.....I am not pulling this out of my ass as you seem to suggest.

But if an individual projects their income up to 10 percent higher than shown in electronically available data such as a prior tax return, there will be no questions asked. If there is more than a 10 percent discrepancy, the exchanges will ask for more information, such as a pay stub. If an applicant is unable to provide such data, the regulations allow the exchanges in 2014 to rely on the individual's "self-attestation" to determine the subsidy. This applies only when someone overestimates their income, according to a spokeswoman for Health and Human Services.

http://www.kaiserhealthnews.org/Stories/2013/August/12/income-projections-low-income-Obamacare-state-medicaid-marketplace-exchange.aspx

[VanillaRhapsody]

153. the TREASURY Dept said so....

do you control the Treasury?
This is a Federal not a state issue....they are NOT going on the State exchange...they are going on the FEDERAL exchange.

[dsc]

156. the states and the feds share info all the time

for instance dead bead parents get their tax refunds held up all the time despite the fact child support is a state issue.

[VanillaRhapsody]

157. but it supercedes the states.....

they are "projecting a 10% increase in salary" that is NOT unreasonable....are they expected to be within a 1% margin of error?

[dsc]

159. you haven't a clue how much they would be projecting or not

but that is also irrelvent. what is relevant is by saying they are making over the poverty level, when they aren't, they are claiming enough income to not qualify for say food stamps. Again, I don't know if the states will investigate or not on the grounds of those estimates. But you don't either. The feds issue info to the states all the time so that info being shared isn't outlandish. Once shared what will the likes of Rick Scott and Rick Perry do? You have no idea, neither do I.

[VanillaRhapsody]

160. If you read the Kaiser Report article it SAYS right there that IF you project up to 10% over your

end of year salary...NO PENALTY will result. PERIOD...it is NOT about them penalizing you...they don't have access to the Affordable Care Act website! Rick Perry is NOT going to have access to the data you provide to Healthcare.gov.

10 Freaking percent....its called being income optimistic...the programs those governors control require your ACTUAL salary WITH substantiation....THAT is the difference between the two.
Sheesh!

[dsc]

165. For the love of God

I don't know how to express this more clearly. I am not, repeat not, repeat not, talking about what the feds will or won't do. I agree the feds will not penalize you for either over or under estimating your income. I am saying, because I do think it is possible, not certain, but possible, that states, those are the entities run by governors and not the people running the exchange, might use the fact you are telling the feds that you think you will make more money than you are right now, as an excuse to make you file paperwork to justify your income based benefits. Again, I don't say I know this will happen, But I do think it is something a person should think about before over stating their income. I honestly give up if you don't have it now.

[lumberjack_jeff]

174. If you're in a state that didn't expand medicare

and you overstate your income for the purposes of getting to the 100% of FPL threshold, because you still don't qualify for medicaid, you're doing so to qualify for a subsidy to purchase private insurance on the exchange.

You're not "filing paperwork" to apply for "income based benefits" from the state in question.

If you are also applying for food stamps or some other non-healthcare related help, your income verification comes from your prior year's tax return.

[dsc]

175. and of course the state won't make you reapply

when the federal government tells them you are claiming you are going to make 15,000 instead of the 8,000 you told them. I surely wouldn't put it past them to make you go through all kinds of hoops.

[lumberjack_jeff]

176. The IRS isn't suggesting you falsify your next years tax return.

In 2015, your verified income is the $8000 stated on your 2014 tax return. This year, your 2013 tax return is your verified income. The estimates you provide to the exchange don't carry any more weight than the estimate you provided to woman you dated last weekend.

The question becomes whether the IRS will disallow your ACA tax credit if you break an arm and make less than 90% of FPL for the year.

[dsc]

178. you do realize they call you in to reapply for a variety of reasons

for instance your ex husband or wife can call them and tell them you are secretly making more money, and walla you are made to recertify. Yes, they base the initial decision on IRS forms, bank accounts etc but the later ones can be on anything they wish.

[Tsiyu]

164. Thank you for bringing up the point you are making

Claiming a higher income may not hurt you in the health exchange, but could hurt you if the state decides to use those figures to determine benefit levels for state programs.

This is why many lower income people will not sign up.

But as usual, the very poor are shuffled aside when there are questions.

[VanillaRhapsody]

166. the STATE won't have those figures....these are the states that DIDN'T expand Medicaid...

how the F are they going to get that data....hire the NSA?

[stevenleser]

167. They really don't seem to care about anything other than maintaining their anti-ACA talking point.

This "what if" bogeyman they are raising really doesnt make sense at all for several reasons but that doesnt stop them.

[VanillaRhapsody]

169. I know right?

but but but Rick Perry....its ridiculous...

[progree]

172. "how the F are they going to get that data...?" Request it. DERP. If it isn't already part of

their information sharing system.

[sabrina 1]

180. Inartful is lying. You advised someone here to lie in order to get coverage. It may come as a shock

to you, I don't know, but most people I know would never lie on an official form, in fact they mostly do not lie at all. The fact that you do not believe the OP amazes me. She is a longtime DUer and there is virtually no reason to believe she is lying, none whatsoever, nor is their reason to believe the other poster has some ulterior motive in asking a VERY LEGITIMATE QUESTION. Perhaps you don't know anyone who is receiving temporary assistance, but I do, and the question you were asked, in response to your advice to lie, occurred to me also, and I am sure many others who are not wealthy people.

I am sick to death of people being attacked and accused of having ulterior motives here if they dare to report the problems they are having with getting HEALTH CARE. Do you understand what a serious issue this is for many people, or is it all political for you?

This place has changed to the point I do not recognize it anymore. Everything is politics, with little or not compassion for ACTUAL PEOPLE.

No wonder so many good people have moved on ...

[progree]

181. Very well stated sabrina_1 particularly how DU has been devolving into a McCarthyite dystopia

of ideological purity fanatics, (as I would describe it). Reminds me of the book / movie 1984 by George Orwell. The precise exact opposite of progressive.

[stevenleser]

182. Oh please, sell the melodrama elsewhere. The Obama administration said this was OK to do.

If you have a problem with it, address it with them.

[progree]

183. ONCE AGAIN: What will state agencies will do with information that conflicts with what

applicants put on say their application for foodstamps or Medicaid or cash assistance? The Kaiser piece does not address the issue of what the states might do about substantially different income estimates in what is on a food stamp application and what is on an ACA application. And neither have you to date.

Do you think some ACA regulation has ended all income verification and eligibility enforcement in the state-administered programs?

Why oh why do you keep dodging and ducking the issue?? Do you really think anyone even casually reading bits and pieces of this thread isn't noticing?

[stevenleser]

184. That was not what she was manufacturing outrage about. nt

[sabrina 1]

185. It's melodrama now to object to being told to lie on official forms? That's a pretty low bar

we are sinking to when asking that Americans have access to Health Care without having to lie and then risk losing other much needed benefits.

We DID take it up with the Obama Administration. Not sure where you were when this Bill was being discussed but most of the Democrats I know were very vocal wrt such a huge issue for the people of this country. Not many Progressives had any say in the passage of the bill, unfortunately so now we are stuck with something so complex that the average person who isn't spending all day online, mainly the poor working class and older people, cannot negotiate all the twists and turns in this maze of difficulties they need to get through just to try to get something that is a Human Right in most developed nations.

And if you are going to advise people how to do it, if lying is the only way as you claim, then you need to understand that most people will object to that.

[stevenleser]

56. More on this...

http://www.kaiserhealthnews.org/Stories/2013/August/12/income-projections-low-income-Obamacare-state-medicaid-marketplace-exchange.aspx

[VanillaRhapsody]

163. Same link I provided....

but they won't seem to read it...

[progree]

173. And you won't address what state agencies will do with information that conflicts with what

applicants put on say their application for foodstamps or Medicaid or cash assistance. The Kaiser piece does not address the issue of what the states might do about substantially different income estimates in what is on a food stamp application and what is on an ACA application.

[Drale]

26. Indiana does infact have an exchange

theres not that big of a selection but my girlfriend by a silver plan with a low deductible for 66 bucks a month. You didn't even try to look it up if you say Indiana doesn't have an exchange.

[Brigid]

30. Nothing came up when I worked with the navigator today.

But when I checked out healthsherpa, I got some plans to come up, so I tried to enroll in one. I got a message saying that I was ineligible for a subsidy because I should be eligible for medicaid. Now I know why nothing came up on healthcare.gov.

[progree]

54. You MUST enroll at the appropriate government health exchange to get a subsidy

For most states (which don't have a state exchange) that is healthcare.gov. For states with state exchanges, like Covered California in California or MNSure in Minnesota, you MUST enroll at the state exchange to get the subsidy for private insurance.

Many websites, including HealthSherpa.com, Medica, HealthPartners, and MNSURE, say that.

What the rules are for people who are Medicare-eligible, that I don't know. But since you are getting advice to state your income high enough to qualify for private insurance with the subsidy, I felt I should mention this.

On Edit 132a CT I see your state is Indiana and that it doesn't have a state health exchange, so yeah, if you want to get the subsidy for private insurance, you MUST choose the plan and enroll at healthcare.gov

[Drale]

93. Yes but if you type Indiana Health Exchange into Google

you know what you get? The 1st result is an info site and the 2nd is Healthcare.gov for people in Indiana, so if this poster couldn't find it they didn't really look.

[steve2470]

95. a bit more info here

Current Status:

18 states will have a state-run exchange: California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Vermont, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Utah, Washington.

7 states will have an Exchange run via state-federal partnership: Arkansas, Illinois, Michigan, West Virginia, Delaware, Iowa, New Hampshire.

26 states will have a Federally-facilitated Exchange (FFE): Alaska, Alabama, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, Wisconsin,Wyoming.

http://aahivm.org/insuranceexchanges

[Earth Bound Misfit]

116. You're missing NJ from your listing of the 26 states n/t

[steve2470]

117. sharp eye, yea they missed it nt

[Earth Bound Misfit]

120. Not sharp, I only noticed cuz I live there lmao n/t

[progree]

97. I think Brigid in #30 was saying that healthcare.gov came up dry

which would be true for someone in Indiana putting in a below-poverty income (but above whatever Indiana's Medicaid guideline is)

30. Nothing came up when I worked with the navigator today.
But when I checked out healthsherpa, I got some plans to come up, so I tried to enroll in one. I got a message saying that I was ineligible for a subsidy because I should be eligible for medicaid. Now I know why nothing came up on healthcare.gov.

Its not that she and the navigator didn't look, according to #30. Though I can't say why healthsherpa said she "should be eligible for Medicaid" to use her words.

I went to healthsherpa.com, and put in a $10,000 income and it said, "Your income appears to be too low. You can double check by applying for a plan. Otherwise you should look into Medicaid." (Quite a bit different than "should be eligible for Medicaid&quot Got the same message at $11,000. At $12,000 got a subsidy of $306 (for a 35 year old person - I didn't bother to change the default age), and the Medicaid message went away.

[progree]

58. I don't think so. Healthcare.gov lists plans for Indiana

Last edited Sun Mar 30, 2014, 03:43 AM - Edit history (1)

If there is a state exchange, healthcare.gov will direct you to that exchange.

One can find ACA-compliant plans on unofficial exchanges like HealthSherpa.com and insurance company websites. (In fact all new individual and family policies sold in the U.S. must be ACA-compliant). However, if one buys private insurance anywhere but the appropriate exchange, and I strongly believe (after much googling and trying out healthcare.gov) that is healthcare.gov for Indiana residents, than one will NOT get the subsidy.

[hedda_foil]

33. Since Indiana refused to set up its own exchange, the feds set it up.

Do you fall into the group that's between the state's Medicaid income level and 133% of the federal poverty line?

[VanillaRhapsody]

34. First of all you are in a Red State....that didn't expand Medicaid. THAT is not President Obama's

fault....as he himself has said....the reason there are not enough people WITHOUT insurance signing up is BECAUSE of so many Red State Govs NOT expanding Medicare. This means those folks that the Affordable Care Act was needed by THE MOST (because most of the uninsured are IN Red States) would not be receiving the much needed help. But you cannot blame that on the man.....he was planning for far fewer states outright balking than there currently are.

BUT

this does point out a major FACT that the Rightwing doesn't want to acknowledge. Even though this many Red States are NOT expanding Medicaid....they have STILL nearly reached their goal of 7 million people. NOW...what's interesting IS...this means that even more that already HAVE coverage but are finding less expensive plans on the Affordable Care Act Marketplace......which means....TADA...its WORKING! It is bringing down the cost of health insurance....this means that private not on the Affordable Care Act policies are going to have to compete with those prices.....


WINNING!!!

[spanone]

85. with mike pence as your governor, you are as screwed as the folks in tennessee

[Lex]

8. Well that settles it. nt

[jwirr]

11. Her profile says she is from MO. If I am not mistaken they do not have Medicaid Expansion.

[Brigid]

12. I was born in MO.

I live in IN.

[Junkdrawer]

14. Now you've done it, reporting what you see instead of what you're told...

The modern Democratic Party is not built for such a strain.

Oh, washout? Same here.

[Puzzledtraveller]

150. No joke

I'm a medicaid caseworker and have been doing ACA related applications, expanded Medicaid, APTC, QHP since October 1. Nearly all of the clients I did applications for were approved for Medicaid. I can count on one hand the number who were approved for advanced premium tax credits and none that actually applied the credit and purchased a plan. The clients I had who were just a little bit over the income limit for Medicaid do not have the extra money even to pay the premium on a bronze plan after subsidies.

[Drunken Irishman]

17. Why was it a washout?

You don't specify. I can only assume it's because your income falls below $11,500 a year and because you live in a state like Indiana, there isn't an expanded Medicaid option for you. If that's the case, blame the Supreme Court. The original bill mandated every state had to offer an expanded version of their Medicaid program to individuals who made too little to qualify for the tax credit. In 2010, the Supreme Court ruled states could not be forced to expand its Medicaid program.

[Brigid]

20. The problem is that some of us fall through the cracks.

Last edited Sun Mar 30, 2014, 10:41 AM - Edit history (2)

That's because this is a Frankenstein's monster instead of an actual, working health care system. I hope this costs Pence, and any other state governor who didn't expand Medicaid, big in the next election.

[VanillaRhapsody]

36. No its not.....Its quite simple for those of us living in states that HAS expanded Medicaid

that is why we know you are incorrect...those in Blue states are not having these problems you are describing....it is MOST certainly not a "washout" in those states....people are QUITE pleased.

[Brigid]

39. You didn't read my post closely.

I said "for me." And I live in a state without expanded medicaid. So for me, it's a washout. For others, it isn't.

[VanillaRhapsody]

42. But you missed the point....its "washing out for you" is because of your Governor....

not the Affordable Care Act.....

For millions of us...its quite the opposite of "washout"

I suggest you join others in your state and demand your Governor take care of its less fortunate! President Obama and his Affordable Care Act would LOVE to help you .....he is offering help to you free of charge to your Governor...who is STANDING in your way of getting that FREE help!

Your governor is staring a gift horse in the mouth.....and people in your state WILL die. Time to take pitchforks and torches to the State House! Petition your Government to do what is right....LOTS of other folks in your state are doing just that...

Though I know its so easy to just sit behind a keyboard and complain to DU'ers it's a washout...but you gotta hit the bricks......DEMAND IT....Just throwing up your hand and saying "its a washout" is just giving up. Not when you are sooooooo close. You have ONE person standing in your way...just ONE...and what you are asking for is FREE....for the next guy. Work to get the "next guy".

[Bluenorthwest]

70. Did you miss the part where she blames her Governor? I saw it.

She typed: "I hope this costs Pence, and any state governor who didn't expand Medicaid, big in the next election."

[VanillaRhapsody]

101. Then place the blame where it BELONGS......not on the ACA

did YOU miss that part?

[Marr]

177. Read? Who bothers reading?

The subject line was critical. Better to just go directly into Defensive Mode.

[pnwmom]

61. Blame that on the Supreme Court and the governors who choose not to take Federal funds to expand

Medicaid. The intention of Congress in the ACA was that all states would expand Medicaid, but the Supreme Court allowed states to refuse it.

[dsc]

72. you might try reading her or his posts

in it the person says, I hope Pence loses his job over it. Pence is the governor of Indiana.

[VanillaRhapsody]

108. then why the Affordable Care Act detraction nonsense...

[karynnj]

147. No - the bill as written required Medicaid expansion

Had the Supreme Court not given the power to the states to say no, your experience would have been like my NYC daughter's. You would have gotten a message that you qualify for Medicaid with links to the options available.

Your state (incidentally where I was born and lived through college - in two blue oasis Lake county and Bloominton) actually threw away federal money for ideological reasons. This created the very large crack - but the blame should not fall on Obama, the Congress, or the people who designed the program. The villain is your Governor and legislature.

[Tarheel_Dem]

18. Why is it the people having the most "trouble" with the ACA, are the same ones.....

Oh, never mind. I figured it out.

[Brigid]

23. Ha ha.

Hilarious.

[VanillaRhapsody]

37. Good point....

funny that huh?

[Tarheel_Dem]

43. Only if you believe in 'ye Gods of coincidence. These vague stories sound awfully....

vague in their criticism, and a lot like those Koch sponsored ads that keep getting fact checked, and shot down. The o.p., in it's vagueness, speaks volumes. But I guess you don't wanna give out a lot of detail, if you're afraid someone might actually find a solution to the "problem", cuz then you're just left with a solved problem, and no further reason to complain. Complaining is so much more fun. See how that works?

[VanillaRhapsody]

44. and its almost like they are timed every so many days....

its much to regular to be random...

[Tarheel_Dem]

46. There you have it. "Coincidence + Coordination" = ?????

[VanillaRhapsody]

47. I GOT IT!

Griefers!

[Tarheel_Dem]

50. !!!

[ScreamingMeemie]

81. As I said to your friend, cut it out and see my post to him/her.

Quit trying to paint this. In a nutshell, not a fan of a lot that this administration has done/not done. Huge fan of ACA. Stop it.

Thanks

[VanillaRhapsody]

100. I am not painting....it just IS what it is...

So please do not tell me what to do...

Thanks...

(not a fan of this administration is sure an understatement) Wonder why it is ONLY those that are "not a fan of this administration " that seem to have "these problems"?

[ScreamingMeemie]

102. Apparently it isn't... Love ACA. So yes. Cut. It. Out.

And put down the blasted paintbrush already. It's tiresome.

[ScreamingMeemie]

80. Hey! HEY! Now...

Enough, all right?

One, I have had HUGE issues with this administration re:NSA,drones, etc...

I have NOT had a problem with the ACA. So just stop. Okay?

[Earth Bound Misfit]

19. So sorry you're not getting help...

Last edited Sun Mar 30, 2014, 09:52 AM - Edit history (1)

I'm in New Jersey and will begin receiving SSDI April 1st and will lose my Medicaid eligibility the same day... I signed up thru the Marketplace and will receive a $545 subsidy toward the monthly premium ($750.39 without subsidy) and also qualify for an %87 cost sharing reduction ($2000 plan deductible reduced to $750, OOP Max reduced from $6350 to $2200)

I have a serious heart condition (I had a permanent defibrillator/pacemaker implanted March 6th). Without the ACA I would not be able to afford quality insurance and would surely DIE.

[Brigid]

21. I'm glad you're getting help.

But until we have a single-payer system, some of us are going to fall through the cracks. I don't know if we will ever get there.

[lostincalifornia]

29. Well we don't have a single payer plan. Did you go to healthcare.gov? See my links below

https://www.healthcare.gov

Are here are plans for single making less that 42000/year

https://www.healthcare.gov/find-premium-estimates/#results/&aud=indv&type=med&state=IN&county=Brown&age0=35&employerCoverage=no&householdSize=1&income=41000

However, since your state did NOT extend Medicaid you might be in the donut hole. You can try to call someone at healthcare.gov, but I think you are in a catch 22 because of your state

[MADem]

32. You'll fall less through the cracks with ACA than you will with NUTHIN.....

And you're not getting single payer until YOU help elect a Dem House to go with a Dem Senate.

And it needs to be a substantial majority, too.

I'm doing what I can to achieve that goal.

In the meantime, don't make the perfect the enemy of the good, and let people help you with the ACA. You're not getting your single payer this year, or next either, most likely.

You might have it in five years IF you move to VT. They'll be the first state to roll it out, odds are good.

[calimary]

51. THIS^^^^^

The more republi-CONS we get get rid of at the national AND state level, the more Americans will be spared from falling through the cracks.

[Earth Bound Misfit]

60. Well...

"The more republi-CONS we get get rid of at the national AND state level, the more Americans will be spared from falling through the cracks."

...said.

[Nite Owl]

129. If we were to replace some of the

republicans with more blue dogs and third waters it would get the same result. They need to go as much as the republicans.

[TransitJohn]

68. You think we'd get single payer with a Dem House and Senate?

That's adorable.

[VanillaRhapsody]

38. Until your state expands Medicaid...you are still going to fall through the cracks..

there I fixed that for ya....

[Motown_Johnny]

22. That simply can't be true.

Go to this site: https://www.healthsherpa.com/


Go though the steps and it will give you an idea of what you can sign up for. Check the silver plans, they have lower costs based on income (besides the subsidies).

Let me know how it goes and we can start working with the healthcare.gov site.

To bad you started so late, but so long as you get an application started you can finish it after the first.

[Brigid]

28. I gave healthsherpa a try.

Thanks, but I got the same results. They said I was ineligible because I should be eligible for medicaid. Now I know why nothing came up on heathcare.gov today.

[lostincalifornia]

31. That is the problem then. Your state obviously did NOT do the expanded Medicaid. You are in a

catch 22, and you can blame directly the legislature and the governor in your state.

You can try to call somebody at healthcare.gov, but I think you are caught in the donut hole

Yes, single payer would have been the way to go, but it wasn't, and your state is doing everything in their power to see you don't get insurance.

This is why republicans must be voted out

[TheKentuckian]

49. The poster understands all of this. That doesn't provide them any health care though

Nor does it absolve a lot of bullshit that made this a Frankenstein monster of our own and only our own creation or more particularly the actual motivations behind said bull. Or the pretense that the cartel wasn't all up in the Baucus mark which got whittled down even further in the open Senate before becoming otherwise unerringly The Law plus Sanders' side item concessions (that actually turn out to be our only real built in bridges to somewhere besides where we are) and the hastily added (and in my opinion) and less than well thought out MLR as a last ditch effort at some cost containment other than on the consumer end (aka death panel of the self) and the often ethereal "waste, fraud, and abuse".

[VanillaRhapsody]

65. and this poster supports President Obama too right?

and all they did was go to Healthsherpa at the last minute....that is the epitome of disingenuous...

[lostincalifornia]

92. I would not be on the OP. A lot of people are confused, and frankly it was not

Until recently that the administration really started advertising

You are up against the Koch brother and even some dem running away from the aca which is disgusting

[VanillaRhapsody]

98. A LOT of people on DU are NOT confused about the ACA.....they have an agenda...

[lostincalifornia]

106. and DU represents the total population. There is a problem when most uninsured Americans do not

know when the deadline is:

http://www.huffingtonpost.com/2014/03/26/obamacare-deadline-unaware_n_5034275.html

"Six in ten uninsured unaware of signup deadline"

Not everybody has an agenda, nor does everybody who posts on DU spend their life here either

It wasn't until this month that the administration started pushing the advertising for it, and guess what, more people enrolled.

Incidentally, that is not a criticism, that is a fact

[VanillaRhapsody]

107. No it doesnt....

it represents those that "support and want to see more Democrats elected"....

Or are you trying to say there are lots of folks on DU that do not?

[lostincalifornia]

111. My sense is the vast majority on DU want Democrats elected, but there appears to be some who express

a more ambiguous view

[VanillaRhapsody]

114. "ambiguous" my aunt Fanny...

[lostincalifornia]

122. Lol

[VanillaRhapsody]

151. not everyone is "confused" Do you seriously think there are no stealth ACA deniers on this forum?

[lostincalifornia]

155. Little bit of a delayed response VR when we first had this discussion. of course there is

[VanillaRhapsody]

158. then WHY are you defending ANYONE who does.....

[lostincalifornia]

161. I do not know the OPs thoughts

[VanillaRhapsody]

162. I know it was dripping with contempt for President Obama and the Affordable Care Act

I know THAT when I see it....it is not my first Summer out.

[progree]

171. ".it is not my first Summer out." No quite the opposite. You've been out in the sun too long,

As for the OP, I saw disappointment in someone who needs health care coverage not being covered. I would be pissed too.

[TheKentuckian]

112. I haven't a clue, however they have made it clear here they understand why they aren't covered.

I don't get the focus here, you sound like somebody hollering "HERETIC!" or something and could give a shit about actual people at all or at least not until proper reverence and absolution for the President is displayed and that with an air of "shut the fuck up about your damn pony least it be mistaken for negative feedback"

[Marrah_G]

145. Your posts on this thread are Nasty

Brigid has been here for a long time and is NOT what you are trying to portray her as. Off to ignore you go with everyone else who behaves in such a shitty manner towards other DUers.

[progree]

149. ^--+100. Wow, this reminds me of the Army McCarthy hearings: "at long last..."

when Joseph Welch finally confronted Joseph McCarthy,

"Senator; you've done enough. Have you no sense of decency, sir? At long last, have you left no sense of decency?"

[VanillaRhapsody]

152. Do you think there was no contempt at all in that OP?

and what is your opinion of President Obama by the way?

[progree]

170. Contempt? Sounds like disappointment at not being covered. Only you show contempt for your fellow

progressives with your constant attacking of anyone that is having any kind of difficulties with the ACA or is flat not being covered.

>> and what is your opinion of President Obama by the way? <<

I've been a strong supporter from the very beginning. Cut the crap.

[lostincalifornia]

90. frankly it was the supreme court also. This would not have happened

If they did not rule against the extended medicaid

[VanillaRhapsody]

99. You cannot fight the Supreme Court....

but you can get off your ass and fight your state government and stop blaming Obama for their governor's choice!

[lostincalifornia]

104. Where did I blame Obama? Do you have a comprehension problem?

[VanillaRhapsody]

105. Maybe it wasn't about you....

complex?

[lostincalifornia]

110. Gee really. Exact quote to my post, "You can get off your ass and fight your state government and

stop blaming Obama for their governor's choice!"

I never even implied that it was the Presidents fault governor's choice by that state???

[VanillaRhapsody]

115. did you write this OP?

perhaps it was meant for THEM?

[VanillaRhapsody]

40. you quit at Healthsherpa.....that is all the effort you gave this...

and you deem the whole thing "a washout"?



ppppppffffffffftttttttt!!!!!

[Tarheel_Dem]

45. Must not be all that important. Ya think? Especially at the last minute. n/t

[VanillaRhapsody]

64. I know right......no agenda AT ALL!

[CJCRANE]

63. I'm sure Ted Cruz would like to hear her story:

http://www.democraticunderground.com/10024751966

Although the other posters on his facebook page might have some advice for her.

[Motown_Johnny]

84. There seems to be a "sweet spot" for income

If you go here: https://www.healthsherpa.com/insurance_plans?zip_code=46201#c18097/ppl35/msilver/pPPO,HMO,EPO,POS/hhs1/hhi11500 you will see that you can get a silver plan for $17.00 a month.

Then if you go here: https://www.healthsherpa.com/insurance_plans?zip_code=46201#c18097/ppl35/mbronze/pPPO,HMO,EPO,POS/hhs1/hhi11500 you can get any one of 5 Bronze plans for no cost.

If you play with your income level, then that changes. It seems like if you estimate your income below $11,500/yr. then you become ineligible.


This looks like some crack for people to fall through due to some states not taking the Medicaid expansion.


I strongly suggest going to Healthcare.gov and giving them the numbers they want. You can sort this out later, but it does just seem like a glitch.



I used age 35, non-smoker and an income of $11.500/yr. in zip code 46201. I don't know enough about you to be more accurate (sorry).

[questionseverything]

113. i have read recently only the silver plans

qualify for the reduced out of pocket programs so it seems like the 17/month would be her best choice

[Motown_Johnny]

121. I agree

and I signed up for a silver plan myself.

But no cost insurance is a possibility, I just wanted to point that out.

[lostincalifornia]

27. Curious, why did you wait until now to try and sign up? That is what the national exchange is for

I just read your explanation above, it was because your state did not extend Medicaid

[VanillaRhapsody]

41. *cough* (pre-existing narrative) *cough*

[Warpy]

48. Well, it's not a washout when you develop that chronic disease down the road

because the bastards won't be able to jack the premiums up to price you out, cap the benefits, or make you wait too long for treatment in the hope you'll die first. Best of all, you don't have to be married to a job you hate just to get insurance.

It did do a lot of things that aren't apparent in that monthly bill.

And yes, this country has been hostile to its citizens for a very long time.

[Earth Bound Misfit]

59. ^^ This. n/t

[Tikki]

53. I am so sorry, I guess we each are one of 50 States after all...

and I am pretty sure the repigs don't want some to forget that.


Tikki

[CJCRANE]

62. You don't provide many details but you provide plenty of talking points.

Why not ask for advice and get the issue resolved instead of being passive?

[VanillaRhapsody]

66. because the truth "hurts"....

owwwieeeee !

[ProSense]

67. For every state not expanding Medicaid, spread this around

From January:

More than 7,100 deaths likely from states' rejection of Medicaid expansion: Health Affairs Blog

Harvard and CUNY researchers say death toll from 25-state ‘opt-out’ may be as high as 17,100 annually; hundreds of thousands more will be harmed by depression, untreated diabetes, and skipping mammograms and pap smears

The decision by 25 states to reject the expansion of Medicaid coverage under the Affordable Care Act will result in between 7,115 and 17,104 more deaths than had all states opted in, according to researchers at Harvard Medical School and the City University of New York.

The study, the first detailed estimate of the health impact of the states’ decision to reject the Medicaid expansion (with state-by-state data as well), is being published today at the Health Affairs Blog.

The researchers found that because of the states’ “opting out” of the Medicaid expansion, 7.78 million people who would have gained coverage will remain uninsured. In addition to the thousands of excess deaths associated with that lack of coverage, the rejection of the Medicaid expansion will have the following likely impacts:

* 712,037 more persons diagnosed with depression
* 240,700 more persons suffering catastrophic medical expenses
* 422,533 fewer diabetics receiving medication
* 195,492 fewer women receiving mammograms and
* 443,677 fewer women receiving pap smears

<...>

For example, in Texas, the largest state opting out of the Medicaid expansion, approximately 2 million people who would otherwise have been insured will remain uninsured as a result of the state’s action.

"Texas' refusal to accept federal money to expand Medicaid will result in 184,192 more people experiencing depression, 62,610 more people suffering catastrophic medical expenses, and as many as 3,035 avoidable deaths,” said Dr. Steffie Woolhandler, a professor of public health at the City University of New York who is also on the faculty at Harvard Medical School.

- more -

http://www.pnhp.org/news/2014/january/more-than-7100-deaths-likely-from-states-rejection-of-medicaid-expansion-%C2%A0health-a

Blow By Blow: A Comprehensive Timeline Of The GOP’s 4-Year Battle To Kill Obamacare
http://www.democraticunderground.com/10024714088

[Motown_Johnny]

86. True, but that doesn't help Bridgit.

What we should be spreading around is that you can still get a Bronze plan for no cost. You need you estimate your income at the level they want, but it can be done.

Playing with the numbers at Health Sherpa, it looks to me like if you estimate $11.500/yr. (in IN) you get a choice of Bronze plans where your subsidy pays for your entire premium.

I'm not saying that this is as good as a Medicaid expansion, but people can still get covered at no cost so long as the enter the information the government wants.

[area51]

69. The sum quote.

"It's a country that just does not value its citizens."

And forget morality; our govt. has yet to figure out that if they keep citizens alive, that's more people alive to pay taxes for multiple wars of choice.

[WilliamPitt]

75. Try the 800 number

It's at the bottom of the ACA website.

My dealings with the insurance companies are well known, but signing up via the 800 number was a breeze.

[riversedge]

79. I have heard from friends that the 800 numbers are very helpful

For myself, I had no problems with the website--last December.

[Auntie Bush]

96. Cute baby!

[babylonsister]

82. Here's the number: 1-800-318-2596

I too qualified for Medicaid due to age but GA decided I wasn't worth it and won't be extending Medicaid here. That said, I called the number and spoke to a real person. I am now covered ~
You might end up with your same results, but it wouldn't hurt to call and speak to someone. Just make sure your phone is charged; I imagine it's going to be slam full today with everyone signing up at the last minute.

[elias7]

83. My taxes are up almost 4% due to ACA

And if I made the switch from my current anthem plan in NH to the ACA plan, my premiums would be essentially unchanged.

I still support it however, because I am an obamabot. All kidding aside, I support it because I know it is a step in the right direction, i believe single payer is down the road and I feel this sacrifice on my part means thousands more insured in my state is the right thing.

[Zorra]

87. How do you know your taxes went up specifically due to Obamacare? nt

[elias7]

89. My accountant explained it to me

I am an physician, with an employment status of independent contractor, and so am self-employed. There was an increase in self-employment tax and some other increase that caused quite an increase this year. I can get specifics if I call him.

But the trade off is ok with me...

[progree]

91. Are those 2 new Medicare-related taxes that apply for those above 200k? (enacted as part of the ACA)

Here is a dump of some of my raw notes. HOH = head of household, MFJ = Married Filing Jointly. MAGI = Modified Adjusted Gross Income

# Medicare additional tax 0.9% on any earned income amounts above 200/250 K (Single & HOH / MFJ) of wages, compensation and self-employment income (does not depend on AGI, it’s a tax on earned income just like regular payroll taxes are)

# 3.8% surcharge on net investment income (NII surtax) applies to the lesser of: net investment income #or# MAGI amounts that exceed 200 / 250 K for Single & HOH/MFJ. These thresholds are not indexed for inflation. NII includes, but not limited to, taxable interest, dividends, non-fqualified annuities, rents and royalties, capital gains and passive income from partnerships. Capital gains from the sale of one's primary residence are subject to the tax to the extent the income exceeds the applicable home sale exclusion ($500,000 for MJF and $250,000 for single filers). Excluded fron the new tax are tax-exempt interest (e.g. municipal bond interest payments), distributions from IRAs and distributions from qualified retiermernet plans (e.g. 401k plans). FFI: www.irs.gov/uac/Newsroon/Net-Investment-Income-Tax-FAQs.

Example (amounts in K$): single with 225 AGI which includes 30 of NII. Since the excess AGI of 25 is lower than the 30 of NII, he pays the tax only on 25.

From http://www.irs.gov/uac/Newsroom/Net-Investment-Income-Tax-FAQs and the above example, it is clear that if you have a MAGI below the 200 / 250 k amounts, you don't have to worry about the tax, no matter how much NII you have (as long as it doesn't drive your MAGI over those thresholds -- e.g. a single could have 50 K in non-NII income and 150 K in NII income and would pay zero NII tax because his MAGI is 200 K.).
It’s also called the hospital insurance tax in the Code. - so is correct to call it a Medicare tax.

[Zorra]

94. Thanks. No need to bother, I get it. nt

[progree]

88. My understanding: ONLY SILVER plans qualify for the out-of-pocket subsidies

There are two kinds of subsidies for private health plans bought on official ACA exchanges (like healthcare.gov)

One is a subsidy to help pay the cost of premiums -- it applies between 100% and 400% of the poverty guideline. That is the one everyone is familar with and is applicable to all ACA plans -- bronze, silver, gold, platinum.

There is another subsidy that applies between 100% and I believe 250% of the poverty guideline -- and that subsidizes out of pocket costs other than the premiums. It is my firm understanding that only silver plans qualify for this subsidy, so be wary about getting a bronze plan until you check this out.

Oh, I found it, this from http://www.democraticunderground.com/10024724967#post32

The law's subsidies to help with out-of-pocket costs are only available to people who get a silver plan. - ABC News 1/5/14

For those with especially low incomes, there's a modified Silver plan that slashes coppays and coinsurance. - by Jane Bryant Quinn

By the way, Pollitz offered this tip for those who have an income between one and 2.5 times the Federal Poverty Level: Choose a Silver plan that covers 70 percent of your medical bills. You'll automatically be upgraded to a Gold plan that pays 80 percent of the bills at no extra cost. - Good Morning America, 12/23/13

[Earth Bound Misfit]

119. Spot-on...

Cost sharing reduction: https://www.healthcare.gov/glossary/cost-sharing-reduction/

A discount that lowers the amount you have to pay out-of-pocket for deductibles, coinsurance, and copayments. You can get this reduction if you get health insurance through the Marketplace, your income is below a certain level, and you choose a health plan from the Silver plan category (See Health Plan Categories). If you're a member of a federally recognized tribe, you may qualify for additional cost-sharing benefits.

I live in NJ and qualify for an 87% reduction in deductible,co-pays & OOP maximum. I was limited to I believe 7 "Silver" plans to gain the deduction and the hosp/clinic I am being treated at (Deborah Heart & Lung Ctr) only accepts one of those so the choice was made for me.

More @ Kaiser: http://www.kaiserhealthnews.org/features/insuring-your-health/2013/070913-michelle-andrews-on-cost-sharing-subsidies.aspx

[GoCubsGo]

103. You are not alone.

Same shit, different assholes. My state is not participating in the Medicaid expansion, nor the exchanges. I have no income, so I don't make enough to get a subsidy, because those are only for people who make too much for Medicaid. But, since I have no children, I don't qualify for Medicaid. Since I have no income, I can't afford $400-500/month for a relatively useless "catastrophic" plan. So, I continue to go without.

I don't blame Obama, either. He got the best he could get under the circumstances, and it's helping a lot of people. Just not all of us. And, it's definitely more than anyone else has gotten for people. The blame needs to placed on those who would rather see people like you and me just drop dead, rather than risk some imagined blotch on their political careers. Fuck 'em. I hope there's a hell, because they're all going to burn in it. That includes you, Nikki Haley, you slimy POS.

[trueblue2007]

118. I'm sorry but I don't believe you.

[flamingdem]

125. So why not overestimate or pad your income?

Were you told not to do that?

[Fumesucker]

127. Not everyone is comfortable with dishonesty n/t

[flamingdem]

131. It's not dishonesty, there are plenty of ways to make up the amount

with picking up some work. Plus, they don't seem to mind if you overestimate, this could be one heck of an EASY solution for this so very frustrated person.

[Cali_Democrat]

168. Essentially the problem is voters in red states

Not all voters of course, but the majority of those Republican voters are dumber than a sack of hammers as they vote for politicians who constantly screw them.

Sad.

[Hekate]

128. So many well-informed DUers have shared excellent tips with you. Please check back next week...

...and let us know how it has worked out. That goes for the others who chimed in supporting your complaint. We do care, you know?

One more tip: Every company that offers insurance plans to its employees has an "open enrollment" period each year. That's when you get to review your options and make changes, such as going to an HMO with a doc who acts as a gatekeeper to other services (keeps costs lower) or a preferred-provider plan with a selection of docs in various specialties that you can pick and choose from on your own. Drug formularies also differ from plan to plan, as was well-discussed in Will Pitt's "POS" thread.

The month of open enrollment is critical to your ability to make changes if you choose -- don't shine it on when the ACA's comes around every year. The only other period like it is during the PIE, or Period of Initial Employment -- which is equivalent to what the nation is going through with the ACA right now. Don't waste this opportunity because of fear of change and frustration with the new and strange.

Best of luck to you, Brigid, and to all the others currently struggling with the change. You bear my own sister's name -- an added reason for my well-wishes!

[Cleita]

130. You can blame the insurance companies and the AMA.

They have been at the root of our inability as a nation to get meaningful health care access for all. Get rid of them and maybe we can get Medicare for everyone.

[Marrah_G]

146. Sorry you are going through this

All you can really do now is be vocal to your friends and nieghbors about how the state fucked you and alot of other citizens over for no other reason then to be the party of NO.

[progree]

179. Epistle on data sharing and income verification. And what I would do

First, if you are a single childless adult in Indiana, you are not eligible for Medicaid, no matter how low your income. (If you had a dependent child, cruelly the threshold would be somewhere in the 0-50% of poverty, according to the map below.
http://kff.org/medicaid/fact-sheet/where-are-states-today-medicaid-and-chip/

Per this, in Indiana, 2-person household with a dependent child has an income limit of $247 / month -- that's $2,964 a year, or 18.8% of the poverty guideline of $15,730 for a 2-person household.
http://member.indianamedicaid.com/am-i-eligible/eligibility-guide.aspx

Just so you know this because you have been given advice by one person in this thread to just declare a very low income to qualify for Medicaid. That wouldn't work at all if you are a single childless adult, because even a $0 income won't qualify you for Medicaid.

Per http://www.factcheck.org/2013/09/obamacare-myths/ "There are also IRS perjury penalties, and civil monetary penalties spelled out in the Affordable Care Act for providing fraudulent information."

I'd want to know more about that before relying on a Kaiser Health News article.

Google: welfare information sharing detecting fraud

You have also been told in this thread that all the state and federal agencies do to verify income in 2014 is to look at your 2014 income tax return when you file it in 2015. That appears to be true in the case of the ACA subsidies. But it is assuredly NOT true in most / all states when dealing with eligibility for state-administered programs such as food stamps, cash assistance, and yes, Medicaid.

What happens in Minnesota, my state, is that they ask about one's income this month and next month. And they monitor electronic databases (see below) and ask questions if there are significant discrepancies. Some of these databases report income as it occurs in near real time. For Medicaid, they also ask one to reverify everything every 6 months.

Nobody has provided a link to anything saying that the state agencies will stop their income verification procedures or penalties for mis-reporting income. These include the two links that have been presented in this thread innumerable times (neither which addresses state agencies, or for that matter, federal agencies other than the IRS which administers the ACA subsidies and penalties):

http://www.hsaforamerica.com/hsablog/income-estimates-aca-subsidies/

http://www.kaiserhealthnews.org/Stories/2013/August/12/income-projections-low-income-Obamacare-state-medicaid-marketplace-exchange.aspx

Here, as an example is what Minnesota does for data sharing in SNAP and the various cash assistance programs, where they also ask for one's income for this month and next month:

https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5223-ENG

... you must report changes which may affect your benefits to the agency within 10 days after the change has occurred. Applicants – Report these changes to your worker when the change happens. This includes the following for everyone in your household: (etc. etc.)

...

Notice about the Income and Eligibility Verification System and Work Reporting System

What is the Income and Eligibility Verification System (IEVS)?

The government has a way to check income. It is the “Income and Eligibility Verification System” (IEVS). The law has us check your income with other agencies. We have to check income for all who ask for or get cash assistance benefits. This includes your children. We need Social Security numbers (SSN) for anyone wanting help. If you have no SSN, you must apply for one. Apply with your human services agency. You must report all SSN’s to your worker.

What is the Work Reporting System?

Minnesota employers must tell us when they hire someone. This information is used by the Child Support Program. We also use this information to see if a new employee is getting help from any of the programs listed on the first page of this application.

What facts will we get and how will we use them?

We check with other agencies about your income, assets and health insurance. If you did not tell us about all of your income or assets, we will refigure your aid. Your aid might go lower or stop. If you get aid you should not be getting, we may use these facts in civil or criminal lawsuits.

How do we use it?

If the employee is getting help from any of these programs, the worker gets a notice. If the client did not report the new job, the worker will contact the client. The worker may ask the client to show proof about the job. The client may need to give the agency permission to check the facts with the employer. If a client does not help us check the information, they will lose benefits.

Agencies we get information from

We must trade facts with these agencies:

# United States Social Security Administration (SSA) – We get records of self-employment earnings, retirement
income, survivor’s benefits, disability payments, Social Security (RSDI), Supplemental Security Income (SSI).
# United States Internal Revenue Service (IRS) – We get records of unearned income (like interest and dividends).
# Minnesota Department of Employment and Economic Development (DEED) – We get records of wages and pay and facts on Unemployment Insurance.
# Minnesota Office of Child Support Enforcement
# Agencies in other states that manage:
. . Unemployment Insurance, Cash assistance, SNAP, Child support enforcement, SSI state supplements

These agencies have the right to get certain facts from us about you. They have to use those facts for programs like RSDI, child support enforcement, cash assistance, SNAP, Unemployment Insurance, and SSI.

We will tell you if facts from other agencies are not the same as the facts you gave us. We will tell you what facts we got, the kind of income or assets, and the amount. We give you 10 days to respond in writing to prove if our facts are wrong. We will ask you to show proof of income, assets, or health insurance you did not report or that we could not verify. You may need to give us permission to check the facts with the source of data. We will tell you what happens if you do not sign for permission or do not help us.

No state agency to my knowledge relies only a tax return that is filed a year later for a couple of reasons -- obviously it is nearly 2 years from when 2014 benefits begin, to when the 2014 tax return must be filed (October 15, 2015 for those who ask for an extension).

And many people in poverty don't file tax returns. The threshold for when one must file a tax return for 2013, for example, is $10,000 for a single individual. (Although the vast majority of people under that income level -- and somewhat above that level too -- would benefit by filing tax returns, particularly with the earned income tax credit and the child tax credit (in effect it is a negative income tax).

(A low income self-employed single parent friend of mine paid no income tax during the year (either through withholding or estimated tax payments) and got a $900 income tax check from the federal government. That was what was left over after they paid her $2500 FICA taxes! Effectively a $3400 negative income tax, of which $2500 went to pay FICA taxes).

I'm very sorry to hear about your health circumstances. I'm sorry you have been subjected to such nasty attacks in what purports to be a progressive forum.

That said, upon reading http://www.democraticunderground.com/1050373

If literally my life was at stake like that, I wouldn't hesitate to "merely miscalculate" my annual income to above the poverty level, and then get a silver plan, not a bronze plan (that's a whole separate thread).

Problem: open enrollment ended March 31. But since you talked to a navigator and accessed healthcare.gov, you may qualify for extra time (but I think that extra time runs out April 15). Your navigator might have to sign something too, if you didn't leave any electronic trail (start an application say) on healthcare.gov.

There are a number of other qualifying circumstances to enrolling outside the open enrollment period ...

And there's next year -- open enrollment begins November 15 for coverage beginning January 1, 2015.

As an aside, for people who may be eligible for Medicaid, there is no open or closed enrollment periods - you can apply any time of the year, and, if accepted, get coverage within a month or so.

Anyway, good luck and take care