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Exchanges Are Mistakes...not Markets
- Thread starter Yagents
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- #82
humm.....how accurate is this.....
Everything you need to know about Health Care Reform (ACA) beginning in 2014 - Health Insurance Quote
"Subsidies will be available based on your age, your income, and your geographic location. Subsidies will not be available for singles that make over approximately $47,000 per year and for families that make over $94,000 per year."
Everything you need to know about Health Care Reform (ACA) beginning in 2014 - Health Insurance Quote
"Subsidies will be available based on your age, your income, and your geographic location. Subsidies will not be available for singles that make over approximately $47,000 per year and for families that make over $94,000 per year."
Well, it's not necessarily inaccurate, just a little poorly written. Subsidies are available based on:
1 - Your Family Modified Adjusted Gross Income (MAGI), as a percentage of Federal Poverty Level
2 - The price of the 2nd lowest cost Silver plan in your area
3 - Whether or not you are eligible for other affordable & adequate coverage
4 - A few other factors like incarceration & legal resident status
So age and location are only applicable in the way they affect the premium for the 2nd lowest cost Silver plan.
His income figures are wrong, though, because "family size" is a big factor in determining the percentage of FPL. For singles, 400% of FPL in 2013 is $45,900, for a family of four it is $94,200, and for a family of 6 it is $126,360, for a family of 8 it is $158,520.
- 8,448
Ann, an excellent explanation of how Subsidies work in relation to income and family size. I didn't know that the FPL is incrementally increased all the way up to 8 person families. For some reason I thought the cutoff was a maximum of 4 person families. Perhaps that's because publications always use a family of 4 for their examples.
The most common mistake I see in news stories has to do with the Penalty-Tax. They say that the penalty for not having health insurance in 2014 is a mere $95.
Most of our telemarketed prospects who don't have insurance have picked up on this $95 from the media. They go silent (for a bit) when our ladies tell them that their IRS penalty is $95 ONLY if their annual income is $9,500 or less. Otherwise, it's 1% of their income... i.e. $50,000 income = $500 check to the IRS in 2015. In addition, penalties can be like blood in the water, causing the IRS to investigate and see what else they can find to feast on!
-ac
The most common mistake I see in news stories has to do with the Penalty-Tax. They say that the penalty for not having health insurance in 2014 is a mere $95.
Most of our telemarketed prospects who don't have insurance have picked up on this $95 from the media. They go silent (for a bit) when our ladies tell them that their IRS penalty is $95 ONLY if their annual income is $9,500 or less. Otherwise, it's 1% of their income... i.e. $50,000 income = $500 check to the IRS in 2015. In addition, penalties can be like blood in the water, causing the IRS to investigate and see what else they can find to feast on!
-ac
You are right, Allen, the media has misled the public. The public doesn't know the penalty is the GREATER OF the dollar amount or the percentage amount. The public doesn't realize the penalties increase in 2015 and 2016 either.
The penalty has a cap to it, also. It is capped at the price of the lowest cost bronze plan in your area. So, if a person makes a million dollars for instance, they won't be charged 1% of the entire income.
The Federal Poverty Level uses any size of family. If you are the Duggards and have 2 parents and 19 kids, then 400% of FPL in year 2013 for a family of 21 is $367,560.
Here's some quick math on figuring 100% of FPL:
1. The first person is $11,490
2. Each additional person is $4,020
So, for 400% of FPL, just multiply the result by 4.
- 8,448
"Next year the federal government should spend over $340 on each person enrolled in the federally-run exchanges just to operate these marketplaces."
Story: Government to Spend Roughly $340 Per Enrollee – Just to Operate Federal Exchanges | FDL Action
No surprise here. More wasteful spending of our dollars.
-ac
Story: Government to Spend Roughly $340 Per Enrollee – Just to Operate Federal Exchanges | FDL Action
No surprise here. More wasteful spending of our dollars.
-ac
- 8,448
A pretty good easy-reading article describing the negative effects of health insurers deciding not to participate in a given exchange, or state.
EXCERPT: "Some experts say the recent departures hint consumers will have limited health-insurance choices thanks to the regulatory burdens of the law. Basic supply and demand dictates that with fewer insurers to choose from, consumers will have limited options and potentially higher prices, says Michael Cannon, director of Health Policy Studies at the CATO Institute.
A similar "exodus" occurred within the first six months of the implementation of the Affordable Care Act, Cannon says, when child-only care was enacted. Seventeen major insurers dropped child-only coverage, in an attempt to skirt the law's new regulations and increased costs. The same may begin to take shape in the individual market."
Read more: Not All Insurers Game for State Exchanges: The Consumer Impact | Fox Business
ac
EXCERPT: "Some experts say the recent departures hint consumers will have limited health-insurance choices thanks to the regulatory burdens of the law. Basic supply and demand dictates that with fewer insurers to choose from, consumers will have limited options and potentially higher prices, says Michael Cannon, director of Health Policy Studies at the CATO Institute.
A similar "exodus" occurred within the first six months of the implementation of the Affordable Care Act, Cannon says, when child-only care was enacted. Seventeen major insurers dropped child-only coverage, in an attempt to skirt the law's new regulations and increased costs. The same may begin to take shape in the individual market."
Read more: Not All Insurers Game for State Exchanges: The Consumer Impact | Fox Business
ac
Wow, thanks for that. We have some clients with tons of kids (8-15) and the IRS charts stop at a family of 8.
For the maximum penalty, is it tied to the minimum Bronze Level Individual plan? I ask because income is household based, so I presume if you are a family you'd be charged up to the minimum you could obtain coverage for your family.
Allen, that $340 per person is about 6% of premium. Just because I looked at some rate filings yesterday, carriers in my area pay (and budgeted for next year) between 5.5 and 7% total premium for all distribution expense (GA override, commission, admin fees). I'm glad to see the government can do things so much better than the free market has managed.
Time to sit back and wait for the media to report stories about "Businessman with $250,000 income eligible for subsidies due to loophole"
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