Obamacare Glitch

Crabcake Johnny

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Obamacare 'Glitch' Allows Some Families To Be Priced Out Of Health Insurance

"Congress said affordable coverage can't cost more than 9.5 percent of family income. People with coverage the law considers affordable cannot get subsidies to go into the new insurance markets. The purpose of that restriction was to prevent a stampede away from employer coverage.
Congress went on to say that what counts as affordable is keyed to the cost of self-only coverage offered to an individual worker, not his or her family. A typical workplace plan costs about $5,600 for an individual worker. But the cost of family coverage is nearly three times higher, about $15,700, according to the Kaiser Family Foundation.
So if the employer isn't willing to chip in for family premiums – as most big companies already do – some families will be out of luck. They may not be able to afford the full premium on their own, and they'd be locked out of the subsidies in the health care overhaul law."
 
This forum crew was once again on top of this concern. Kudos to all of us. Maybe the govey should hire us?

This is quite HUGE, and may inspire some employers to either drop coverage altogether so entire family can get subsidies (best option for everyone), or this could encourage the employer to also pick up some of the tab for the EE's families cost of premium.

As I stated before, employers will be doing most employees and themselves a favor by dropping coverage.

Nancy should have read it before passing it. Only a NON agent politician could have written this law. I'm quite surprised they didn't focus on the families with group coverage.....
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Articles I am reading are stating the families will NOT be subject to the penalty if in this situation.

Plea for More Generous Health Credit Rejected by IRS - Bloomberg

No Penalty

The IRS said in a proposed rule also issued today that most families in such a situation won’t have to pay a penalty to the government if they choose not to buy insurance.

Notably, HHS clarified that the mandate doesn't apply to people who are eligible for Medicaid but live in states that don't take part in the law's Medicaid expansion.

The mandate doesn't apply to people who can't buy insurance for less than 9 percent of their annual salary. HHS clarified Wednesday that the mandate won't kick in retroactively for people who turn down coverage at the beginning of the year because it was deemed unaffordable, but then end the year having made enough money that coverage would have been affordable, after all
 
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No penalty in this situation is great, but those people still don't have insurance, and it appears that the "outside the exchange" market is restricted to very rich-benefit (i.e. very high priced) insurance, too.

The new uninsured class is ....... drum roll please ....... the middle class to upper middle class.
 
Key points that I take away here:

> How many people will be affected is unclear.

> The Obama administration says its hands were tied by the way Congress wrote the law. {Oncve again NO accountability for anything that they break]

> "It is clear that the only way this can be fixed is through legislation and not the regulatory process." [Good luck with that one]

> The affordability glitch is one of a series of problems coming into sharper focus as the law moves to full implementation. [Duh]

> an advocacy group for children, cited estimates that close to 500,000 children could remain uninsured because of the glitch.

These folks are absolute idiots.
 
So, if an employer drops or doesn't allow dependents to join the group plan, I'm assuming this means the family members don't have access to coverage, and WOULD be eligible for exchange subsidies. This could be the way many employers go to keep the group plan in place, but not screw the families out of the subsidy. thoughts?

Why your boss is dumping your wife - MarketWatch
 
So, if an employer drops or doesn't allow dependents to join the group plan, I'm assuming this means the family members don't have access to coverage, and WOULD be eligible for exchange subsidies. This could be the way many employers go to keep the group plan in place, but not screw the families out of the subsidy. thoughts?

Why your boss is dumping your wife - MarketWatch

Please remember that this applies to dependents who are NOT children. The IRS final rule about this subject stated that Employer Group plans cannot exclude children through age 26 via eligibility rules. However, they can exclude other dependents such as spouses and domestic partners via eligibility rules.

Also, it appears that this means that the children are not eligible for subsidies in the exchange if the self-only premium for the parent's group plan is "affordable" (as a percent of family AGI that starts at 2% and grades up to 9.5%), and is "adequate" (meaning it has all the QEHB's required). Even though this leaves children out of subsidy eligibility, I think (but am not sure) that the children could still be eligible for Medicaid or CHIP if they qualified.

I believe it is still unclear if this means the spouse will be able to get a subsidy in the exchange. From what you (Bill) posted from NAHU a few weeks ago, and from what I have read, there are conflicting points, and HHS may need to make a rule about it. The video & 21 page app that HHS recently released about applying for a subsidy seemed to indicate that spouses can apply for a subsidy separately from each other, meaning that a spouse who is ineligible for the employer group plan would get a subsidy. However, other rules seem to point to the conclusion that the spouse would NOT get a subsidy.
 
As usual, Ann is right. Thanks for keeping me on course.

Reminds me of a thread called "anyone getting sick of Ann"...;)
 
Here, this should clear everything up:

Image:
boehnerchart.jpg
 
Here, this should clear everything up:



Oh, thanks! I understand it so much better now! LOL.
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As usual, Ann is right. Thanks for keeping me on course.

Reminds me of a thread called "anyone getting sick of Ann"...;)

You're as much help to me as I could ever be for you. But I can't compliment you more than once in a month, according to STI's forum rules.

Ann is getting sick of Obamacare, I can tell you that. If implementation is delayed, or if it all peters out like PCIP did, then I've spent an enormous amount of wasted time getting prepared for something that never happened!
 
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