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Archive for Tuesday, September 3, 2013

New website to inform Kansans about Obamacare

September 3, 2013

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A new website meant to inform Kansans about the Affordable Care Act went online Tuesday.

At insureKS.org, Kansans can learn about the health insurance options offered through the new federal health care reform law. The Kansas Insurance Department-run website explains the coverage opportunities available through the online insurance exchange, where people in the state can buy insurance and how to find out about federal subsidies to help with the cost.

The website also features an interactive program showing how the 2014 health insurance changes will effect people, an estimator that will calculate premium costs and tax credits for individuals and families, a link to the health insurance exchange, and information about groups offering advice about what’s in the law.

Comments

workinghard 1 year, 3 months ago

Just ran the cost calculator for 1 adult, 28yrs old with no income. Monthly cost would be $177 a month. With no income where would they get the money? Granted, I haven't took a serious look at the whole deal so I must be missing something.

jafs 1 year, 3 months ago

People with no income qualify for Medicaid, not the ACA subsidized exchanges.

Eride 1 year, 3 months ago

I can’t speak to this specific calculator because I have not looked at it yet. I can tell you that in Kansas a single adult with no children and no income qualifies for ZERO assistance in obtaining health care coverage. 

If an individual did not qualify for Kansas Medicaid under the Medicaid eligibility rules prior to the passage of the Affordable Care Act (ACA) then that individual continues to not qualify for Kansas Medicaid.  Further, if an individual has MAGI that is less than 100% of the federal poverty guideline then that individual will not qualify for any assistance when purchasing health coverage from the Kansas health care Marketplace.  In summary, if you are very poor in Kansas, thanks to the state legislature and governor, you almost certainly get no assistance.

Due to the NFIB v. Sebelius decision, states must voluntarily expand Medicaid eligibility to include the new eligibility category that was passed as part of the ACA. Generally speaking, the new eligibility category includes every individual who does not qualify for Medicaid under one of the original Medicaid eligibility categories AND has modified adjusted gross income that does not exceed 138% of the federal poverty guideline.

A state that has expanded Medicaid has this new eligibility category, a state that has not expanded Medicaid continues to have the same Medicaid eligibility rules the state had prior to the passing of the ACA. Kansas is one of 25 states that has not (at this time) decided to expand Medicaid eligibility.  Kansas Medicaid income requirements follow:

“Medicaid Income Requirements In Kansas Children ages 1 to 5: 133% FPL. Children ages 6 to 18: 100% FPL. Pregnant women and infants ages 0 to 1: 150% FPL. Parents/caregivers living with children ages 0 to 18: 30% FPL if more than 4 household members, add $61 for each added member. Medically-needy: $495/month with asset limit of $2,000 for singles and $3,000 for couples. Aged, blind, and disabled: 75% FPL with asset of limit of $2,000 for singles, and 83% FPL with asset limit of $3,000 for couples.”

Continued below..

Eride 1 year, 3 months ago

The lack of Medicaid expansion in Kansas (and the 24 other states who have so far declined to expand) creates a problem when looking at eligibility for premium tax credit and cost sharing assistance for health coverage purchased from a state Marketplace (aka Exchange). 

An individual who is eligible for another form of minimum essential coverage (government-sponsored coverage, employer-provided coverage, etc) is not eligible for a premium tax credit. Following the NFIB ruling, a proposed regulation was floated by the HHS that applies to individuals in states that did not expand Medicaid who would be eligible under expanded Medicaid.

The HHS proposed regulation makes the income threshold to qualify for the premium tax credit for those individuals 100% of the FPL instead of the 138% threshold for individuals who live in states that did expand Medicaid. Therefore, in Kansas, you must make more than 100% of the FPL to potentially qualify for assistance when purchasing coverage from a Marketplace. If you make even 99% of the FPL, you do not qualify for any kind of assistance (unless you are a child or a pregnant women). If you are not a child, a pregnant women, an extremely poor parent with a child, medically-needy, or aged, blind and disabled, you do not qualify for any kind of assistance in Kansas… even if you have little to no income. In other words, if you are an extremely poor, healthy, non-pregnant individual with no children, you have zero access to assistance in Kansas. I suggest you move to a different state.

This problem is entirely the fault of Republican governors and legislatures (and to a degree, SCOTUS) who have refused to expand Medicaid. This assistance “gap” was not intended in the ACA because under the ACA every state was mandated to expand Medicaid to cover these individuals. Inaction in Congress ensures that this gap will not be addressed at the Federal level and state legislatures and governors refusing to expand Medicaid for what can only be viewed as petty, vindictive reasons that defy logical explanation ensures that no fix is coming at the state level.

tomatogrower 1 year, 3 months ago

Hopefully those poor people will make it to the polls and vote out Brownback, but probably not. They will either not vote, or they will vote for him, because of the R next to his name.

elliottaw 1 year, 3 months ago

or they are blocked from voting because they do not have the income to obtain a birth certificate

Carol Bowen 1 year, 3 months ago

Sixteen states declined Medicaid expansion. See http://www.advisory.com/Daily-Briefing/Resources/Primers/MedicaidMap

Some states are already experiencing lower premiums. Insurance company savings from Medicaid expansion somehow.

Kat Christian 1 year, 3 months ago

If you are a single adult you DO NOT qualify for Medicaid in the state of Kansas because Brownback opted out of the exchange. The only ones who qualify for Medicaid are children, pregnant women and diabled individuals. What Brownback is doing is putting it onto the Federal government directly, that way the state is out of it financially. I wonder how some folks will pay for this. It may be cheaper to just pay the $695 at the end of the year instead of paying $1,000 premium.

chootspa 1 year, 3 months ago

He also opted out of a Kansas exchange (and left money on the table, because he's a fiscally irresponsible jerk, but that's a different discussion). However, states that rejected a regional exchange can still use the national exchange.

The particular jerk move that Brownback did in this case was rejecting medicare/medicaid expansion, which means if you fall between the level that qualifies (which is pretty darn low in Kansas) and 138% of the federal poverty level, surprise! You get no insurance subsidy. That pretty much means that if you're part of the working poor in Kansas, you get no help with insurance at all. At least you can still buy it in the exchange and won't be rejected for pre-existing conditions, but you'd pretty much have to live in a cardboard box to afford it.

I hope the working poor remember to thank Brownback for his kindness and "culture of life" next year at the voting booth.

jafs 1 year, 3 months ago

Sorry, I forgot about that.

You're right - single adults won't qualify for Medicaid or for the subsidies. They'll fall into a nasty hole in coverage.

overthemoon 1 year, 3 months ago

Until you get sick or injured. Then you can just tough it up or go bankrupt.

chootspa 1 year, 3 months ago

Letting a treatable condition fester into a permanent disability is always an option, too. It's nice to have choices.

tvc 1 year, 3 months ago

All I gather from the calculator is that as I get older the cost increases and I never get a tax credit.

jafs 1 year, 3 months ago

Well, you must make a lot of money then.

People qualify for subsidies at up to 4x the poverty level. As far as policies getting more expensive the older you get, that's true now and has been for a long time, as far as I know.

tvc 1 year, 3 months ago

I tried it again. At the very low end there were no tax credits, but there were some when I increased the income by smaller increments.

chootspa 1 year, 3 months ago

I was able to get it to give me a tax credit in the estimate with no dependents, but only after I lowered my income by a LOT. Dependents sure do make a big difference.

jafs 1 year, 3 months ago

Yes, that's right.

At the very bottom, the feds thought people would be getting Medicaid, but in states that haven't expanded it, and have very stringent guidelines (like KS), there's a hole below income that qualifies you for subsidies through the exchanges.

If one doesn't like this, one should put pressure on legislators in KS to expand their Medicaid coverage.

The ACA subsidies are designed for people who make more than Medicaid folks but not enough to cover insurance costs on their own.

akt2 1 year, 3 months ago

No help for the healthy, working middle class. A teen and a 51 yr old with no previous diagnoses and on zero medication. Based on income we would pay $420 per month with a $25 tax credit. We currently pay $422 total for these two individual policies to Blue Cross.

chootspa 1 year, 3 months ago

But do you get that through work or individually? I think the point is to lower the costs for people who don't have employer options.

tomatogrower 1 year, 3 months ago

The other day I spent 2 hours trying to get Blue Cross to fix a problem. Everyone says that the government would be inefficient, but believe me, the private sector is doing a great job being inefficient all by themselves. Single payer system would have been nice, then don't hire any of the insurance people to run it. It would probably run smoothly.

elliottaw 1 year, 3 months ago

insurance companies make it hard on purpose, their hope is that you will lose interest and just deal with paying the extra, or not having a procedure/medication. They are in it for the money.

Liberty275 1 year, 3 months ago

"f a consumer has access to employer-sponsored coverage that is affordable and provides minimum value, the consumer will not be able to get tax credits and cost-sharing reductions."

So now we are going to have to pay tax on premiums if we have employer-sponsored health insurance? Wonderful.

jafs 1 year, 3 months ago

I think the tax credits they refer to are the subsidies for insurance costs through the exchanges.

Not whether or not you pay taxes on insurance premiums.

akt2 1 year, 3 months ago

chootspa - These are individual policies that I pay for. I don't have insurance through my work because I don't work enough hours to qualify. So based on what I pay myself for my own insurance and that of my minor child, The Affordable Care Act is not exactly affordable for the average working person. Even if they are healthy. So far a lot of hot air is all it amounts to. I think people will slowly begin to understand this.

jafs 1 year, 3 months ago

According to your numbers, you would pay the same (actually a couple of dollars less) with the exchanges.

If it's affordable now, then it'll continue to be affordable then.

And, about $400 for two people isn't bad at all - many of us pay that amount per person.

William Weissbeck 1 year, 3 months ago

"Affordable" employer provided coverage is a bit of a stretch. Your premiums in your employer plan have to exceed a fairly high percentage of you income before you could shop for a plan on an exchange. My concern is that the insurance companies can estimate the premiums they can set before they exceed this threshold and charge the small business owner who doesn't have leverage to "shop around."

jafs 1 year, 3 months ago

My recollection is that the percentages aren't that high.

Do you have any numbers or sources?

grammaddy 1 year, 3 months ago

ACA also stipulates that your insurance company must use 80% of the money paid in premiums be used for health care. If it's not used, you get an annual refund.

Mike Ford 1 year, 3 months ago

I did the calculator. We have a $28k a year income for two people with no children. We are non smokers. Our insurance at the silver level calculated out to between $1620 and $1640 a year roughly between $120 and $130 for two people. When my company stopped it's United Healthcare Insurance in Feb. 2011 it was $273 a month for me alone. I've also heard that BCBS and Coventry and one other insurance is in the exchange. Truth trumps nonsense that causes unnecessary fear.

Carol Bowen 1 year, 3 months ago

I have Medicare and Blue Cross secondary. I am not expecting changes in my premiums, but I'll take them if they happen. Oh, yes.

My sons have outrageously expensive individual policies with high premiums, high deductibles, and low coverages. The Exchange sets three levels of coverage for comparison. Free market. My sons are not in Kansas. They have already received 80/20 refunds and are anticipating lower premiums. They are middle class and self employed. ACA is helping them. According to AARP, many retirees are helping their children with individual health insurance premiums, so seniors will be getting a break because of ACA, too.

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