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Old 11-20-2013, 07:48 PM   #1
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Poverty Level Cutoff Poverty Level Cutoff
Even if I know some posters have referred to this inquiry, I'm doing it again considering that it's over a month of ACA launch.
The question is the following:
Regarding the Marketplace, in the states that did not expand Medicaid, are the Federal Poverty Levels of 2013 being used for the cutoff to receive tax credits to purchase insurance through the Exchanges?
About a month ago somebody said that that in there experience, the cutoff was 15K which is way above the poverty level of 100% ($11,490).
Looks like the Kaiser Foundation calculator uses the official guidelines, but I'd like to know what is happening in the real world.
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Old 11-20-2013, 09:09 PM   #2
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Ann H on Poverty Level Cutoff - Insurance Forum
 
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Poverty Level Cutoff Re: Poverty Level Cutoff
The IRS is using 2013 guidelines. So it doesn't matter if a state exchange uses 2014, because it is an IRS Federal Tax Credit based on 2013 FPL. The 48 contiguous states and DC have the same FPL schedule. Some people in Florida were finding that incomes of up to $15,000 were causing healthcare.gov to say the person was not eligible for subsidies. I don't know if that has been fixed yet.

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Disclaimer: Hey! I'm not a tax adviser or lawyer! Yes, I'm married to an Accountant, but would you ride in a plane flown by the wife of a pilot? No! So what I say may be somewhat educated, but take it with a grain of salt and ask a true tax adviser or lawyer.
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Old 11-21-2013, 12:28 AM   #3
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Poverty Level Cutoff Re: Poverty Level Cutoff
Originally Posted by Ann H View Post
The IRS is using 2013 guidelines. So it doesn't matter if a state exchange uses 2014, because it is an IRS Federal Tax Credit based on 2013 FPL. The 48 contiguous states and DC have the same FPL schedule. Some people in Florida were finding that incomes of up to $15,000 were causing healthcare.gov to say the person was not eligible for subsidies. I don't know if that has been fixed yet.
CoveredCA's calculator won't show rates or subsidy eligibility unless you're above 15k
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Old 11-21-2013, 09:28 AM   #4
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Poverty Level Cutoff Re: Poverty Level Cutoff ameneses54 is the thread starter for: Poverty Level Cutoff

Originally Posted by Quotebroker View Post
CoveredCA's calculator won't show rates or subsidy eligibility unless you're above 15k
My post was referring to Florida and the cutoff.
I still don't understand how another huge glitch could be occurring regarding the cutoff to get a subsidy, now basically it's a wild guess which will catalyze more fraud in order to be illegible for the tax credits. Although contradicting,It's not really morally wrong to state an income which lets you be in accordance with the ACA law and rights. It's not the consumers fault that the system is messed up.
Customers who are fully and lawfully entitled to subsidies are being denied due to the incompetence of big brother.
Just to make things worse, I've found another glitch. MAGI states that only taxable SS benefits are to be included, but the math if you do so does not compute because if you don't state the full SS benefit, you may not match the cutoff we're talking about.
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Last edited by ameneses54; 11-21-2013 at 10:01 AM.
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Old 11-21-2013, 10:45 AM   #5
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Dave020 on Poverty Level Cutoff - Insurance Forum
 
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Poverty Level Cutoff Re: Poverty Level Cutoff
For those states which did not enact Medicaid expansion, the area between 100% FPL and 139% FPL was supposed to be addressed with BHPs (Basic Health Plans). The BHPs were delayed at least a year so right now any non-expansion state has issues for people above 100% but below 139%.
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Old 11-21-2013, 10:56 AM   #6
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Ann H on Poverty Level Cutoff - Insurance Forum
 
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Poverty Level Cutoff Re: Poverty Level Cutoff
Originally Posted by ameneses54 View Post
My post was referring to Florida and the cutoff.
I still don't understand how another huge glitch could be occurring regarding the cutoff to get a subsidy, now basically it's a wild guess which will catalyze more fraud in order to be illegible for the tax credits. Although contradicting,It's not really morally wrong to state an income which lets you be in accordance with the ACA law and rights. It's not the consumers fault that the system is messed up.
Customers who are fully and lawfully entitled to subsidies are being denied due to the incompetence of big brother.
Just to make things worse, I've found another glitch. MAGI states that only taxable SS benefits are to be included, but the math if you do so does not compute because if you don't state the full SS benefit, you may not match the cutoff we're talking about.
Originally, the taxable portion of SS benefits was not included in MAGI. It was added later by Congress. So, if you are reading an older document, that may be the problem. If it is stated on healthcare.gov that MAGI does not include all of the SS benefits, then there's a problem!

------------------------------------
Disclaimer: Hey! I'm not a tax adviser or lawyer! Yes, I'm married to an Accountant, but would you ride in a plane flown by the wife of a pilot? No! So what I say may be somewhat educated, but take it with a grain of salt and ask a true tax adviser or lawyer.
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Old 11-21-2013, 08:44 PM   #7
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Poverty Level Cutoff Re: Poverty Level Cutoff ameneses54 is the thread starter for: Poverty Level Cutoff

Originally Posted by Ann H View Post
Originally, the taxable portion of SS benefits was not included in MAGI. It was added later by Congress. So, if you are reading an older document, that may be the problem. If it is stated on healthcare.gov that MAGI does not include all of the SS benefits, then there's a problem!
This is how it's stated in healthcare.gov:
MAGI is generally your adjusted gross income plus any tax-exempt Social Security benefits (except for Supplemental Security Income (SSI), which is not counted), tax-exempt interest, and tax-exempt foreign income.

Originally it was only the taxable portion of the SS benefits.
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