Unmarried Couple with Child-- how Would They Get Health Insurance for Child?

[stormmoon]

Let's say Sally and Bob are unmarried, living together, and share a child, (let's call the child John). Sally doesn't work, so doesn't earn any income. Sally claims the child on her taxes (don't ask why), even though she earns no income. Bob earns too much to qualify for medicaid. Let's assume Bob earns 60k a year.

So, obviously, based on the medicaid rules, John's "household" includes John and both of his parents. The income would then be 60k. That makes John not qualify for medicaid, right? BUT, John is claimed on Sally's taxes, and not Bob's. Would Bob be able to get health insurance for John through the marketplace and be able to get subsidies, even if he doesn't claim John on his taxes?
If Bob isn't allowed to put John on his marketplace account, then how would John get health insurance?

How would health insurance work in this situation, assuming that nothing will be changed? As in, Sally will continue to claim John, even though she earns no income.

 

[BeeSelective]

The answer you don't want: buy a policy and pay the premium. Annual enrollment is coming.

 

[Josh]

I'm going to call them mom, dad, and child.

If dad has a job making $60k/year he should have health insurance and I'm guessing mom is on his two? Either way, the child can go on their insurance. If they'd prefer, they can get a child-only policy for the child as well (at least in most states).

 

[adjusterjack]

Let's say Sally and Bob are unmarried, living together, and share a child, (let's call the child John). Sally doesn't work, so doesn't earn any income. Sally claims the child on her taxes (don't ask why), even though she earns no income. Bob earns too much to qualify for medicaid. Let's assume Bob earns 60k a year.

Your premise is ridiculous. Sally has no income yet files a tax return taking a child as a dependent. Sally would have to be rather stupid. Even assuming that she gets a child care credit it would be negligible at best and a fraction of what Bob's tax savings would be if he took Sally and the child as his dependents which would make more sense since he is supporting them both.

So quit trying to come up with ways to game the system. Bob ought to be able to add Sally and the child to his medical insurance at work and if not Sally, then at least the child.

 

[stormmoon]

Your premise is ridiculous. Sally has no income yet files a tax return taking a child as a dependent. Sally would have to be rather stupid. Even assuming that she gets a child care credit it would be negligible at best and a fraction of what Bob's tax savings would be if he took Sally and the child as his dependents which would make more sense since he is supporting them both.

So quit trying to come up with ways to game the system. Bob ought to be able to add Sally and the child to his medical insurance at work and if not Sally, then at least the child.

I'm looking for an answer to my question, I'm not looking to hear who should claim who on their taxes. If you must know the reason why Sally claims the child, it is because Sally is 21 years old and gets to have "independent" status for FAFSA because she claims the child as dependent. Because she gets independent status and has no income, she gets 8k a year of college grants so she can go to college for free.
Let's say Bob makes self-employment income. Obviously, if Bob and Sally get married or if Bob starts claiming Sally and child dependent, then Sally won't be going to college.

 

[stormmoon]

I tried to post a reply, but I don't think it posted... Anyway, what I was saying was, I am looking for specific answers to my specific question, I'm not looking for "advice on how to file taxes". If you must know, the reason Sally claims the child is because Sally is 21 years old and gets "independent" status on the FAFSA because she claims the kid, otherwise she'd have to include her parents' income. Since Sally makes no money, she gets almost 8k a year of grants, so she goes to college for free. If Bob and Sally get married, then Sally won't be going to college, because then Bob's income would count. Bob has too many loans and bills to pay off, so he can't "pay for Sally's college" either.
Let's say Bob's income is self-employment, so no, it is not "from a job". So no, he doesn't just "get health insurance from a job". Like I said, I already included the information in my post, please refer to it and don't add any "additional information" based on assumptions.

 

[aikenhealth]

Why do you assume that everybody offers health insurance? Many small businesses no longer offer health insurance.

 

[LAD]

I had a similar real life situation this past open enrollment season. Unmarried couple had a baby in 2016. Both partners worked, with each earning approximately $20,000/yr. Woman had expensive health insurance through work. Man had no health insurance options through work.

I wrote the man and baby for health insurance. Man applied through "Affordable Care Act" website and was told he did not have enough income to qualify his daughter for a subsidy, and the daughter would be eligible through Medicaid. Local Medicaid plans here are less than ideal, and I told him that.

Signed up his infant daughter for a much better (and less expensive) individual plan - off marketplace - than girlfriend could have gotten through work, man obtained subsidy, and I signed him up for a similar plan.

I inquired about whether or not man was claiming daughter on his taxes - he said he was.

 

[Ann H]

Let's say Sally and Bob are unmarried, living together, and share a child, (let's call the child John). Sally doesn't work, so doesn't earn any income. Sally claims the child on her taxes (don't ask why), even though she earns no income. Bob earns too much to qualify for medicaid. Let's assume Bob earns 60k a year.

So, obviously, based on the medicaid rules, John's "household" includes John and both of his parents. The income would then be 60k. That makes John not qualify for medicaid, right? BUT, John is claimed on Sally's taxes, and not Bob's. Would Bob be able to get health insurance for John through the marketplace and be able to get subsidies, even if he doesn't claim John on his taxes?
If Bob isn't allowed to put John on his marketplace account, then how would John get health insurance?

How would health insurance work in this situation, assuming that nothing will be changed? As in, Sally will continue to claim John, even though she earns no income.

At Open Enrollment, they can use the Exchange, or go Off-Exchange to:
1 - Buy a policy for Bob and his child, with no subsidy
2 - Or buy a policy for just the child, with no subsidy

Forget the subsidy. The Dad doesn't qualify alone. Mom doesn't qualify with or without the child. Dad can't use his child on his subsidy app because his child is not on his tax return.

Mom can check into Medicaid or pay the full premium for a private-pay policy (no subsidy).

In Medicaid expansion states, the child could qualify for Medicaid because they use the ACA rules for defining a "household" (i.e. whoever is on the same tax return). If you are in a non-expansion state, ask your state's Medicaid what the eligibility rules are for the child.

 

[kgmom219]

At Open Enrollment, they can use the Exchange, or go Off-Exchange to:
1 - Buy a policy for Bob and his child, with no subsidy
2 - Or buy a policy for just the child, with no subsidy

Forget the subsidy. The Dad doesn't qualify alone. Mom doesn't qualify with or without the child. Dad can't use his child on his subsidy app because his child is not on his tax return.

Mom can check into Medicaid or pay the full premium for a private-pay policy (no subsidy).

In Medicaid expansion states, the child could qualify for Medicaid because they use the ACA rules for defining a "household" (i.e. whoever is on the same tax return). If you are in a non-expansion state, ask your state's Medicaid what the eligibility rules are for the child.

What she said.

Add on...if the college offers policies (and it probably does) mom can cover the baby there. And the university plan OEP is probably right now.