Hurdles for ObamaCare in 2nd Sign-up Season

[FLM2]

Originally Posted by Yagents View Post

This one's a doozy (LMAO):

News from The Associated Press

Rep. Bill Pascrell, D-N.J., said in an interview that he disagrees with making people pay back part of their premium subsidy. That would happen if someone made more money during the year and failed to report it to HealthCare.gov.

"Why should individuals be punished if they got a bump in salary?" said Pascrell. "To me, this was not the ACA I voted on."

Sure it is............you read it.......right?
What a dip$hit.......what is in the water up there?
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Rep Pascrell is dead on, 100% right. Clawback, for me, is one of the worst aspects of the ACA and should be eliminated. This can be done very simply by using prior year income as the determining factor for subsidies and having exceptions allowed for those whose income will be lower in the year of the subsidy due to job loss or change in status. Those exceptions would be the only ones needing audit or being subject to clawback.

The presence of clawback makes it difficult for me to make any recommendation to a client about a subsidized plan without spending 5 minutes talking about what could happen. It is also prone to fraud as it is so easy to put in a number that is incorrect just to maximize a subsidy.

 

[KennyWest]

Originally Posted by Yagents View Post

This one's a doozy (LMAO):

News from The Associated Press

Rep. Bill Pascrell, D-N.J., said in an interview that he disagrees with making people pay back part of their premium subsidy. That would happen if someone made more money during the year and failed to report it to HealthCare.gov.

"Why should individuals be punished if they got a bump in salary?" said Pascrell. "To me, this was not the ACA I voted on."

Sure it is............you read it.......right?
What a dip.......what is in the water up there?
----------------------------
Rep Pascrell is dead on, 100% right. Clawback, for me, is one of the worst aspects of the ACA and should be eliminated. This can be done very simply by using prior year income as the determining factor for subsidies and having exceptions allowed for those whose income will be lower in the year of the subsidy due to job loss or change in status. Those exceptions would be the only ones needing audit or being subject to clawback.

The presence of clawback makes it difficult for me to make any recommendation to a client about a subsidized plan without spending 5 minutes talking about what could happen. It is also prone to fraud as it is so easy to put in a number that is incorrect just to maximize a subsidy.

Well Put!! Amazing how many people, and it is moreso with those in lower incomes, who have little clue how much they make.

 

[Ann H]

Originally Posted by Yagents View Post

This one's a doozy (LMAO):

News from The Associated Press

Rep. Bill Pascrell, D-N.J., said in an interview that he disagrees with making people pay back part of their premium subsidy. That would happen if someone made more money during the year and failed to report it to HealthCare.gov.

"Why should individuals be punished if they got a bump in salary?" said Pascrell. "To me, this was not the ACA I voted on."

Sure it is............you read it.......right?
What a dip.......what is in the water up there?
----------------------------
Rep Pascrell is dead on, 100% right. Clawback, for me, is one of the worst aspects of the ACA and should be eliminated. This can be done very simply by using prior year income as the determining factor for subsidies and having exceptions allowed for those whose income will be lower in the year of the subsidy due to job loss or change in status. Those exceptions would be the only ones needing audit or being subject to clawback.

The presence of clawback makes it difficult for me to make any recommendation to a client about a subsidized plan without spending 5 minutes talking about what could happen. It is also prone to fraud as it is so easy to put in a number that is incorrect just to maximize a subsidy.

However, that is not what Rep Pascrell said. He said, "Why should individuals be punished if they got a bump in salary? To me, this was not the ACA I voted on."

I agree that subsidy eligibility should not require a crystal ball to predict future income. However, that is a different concept than Pascrell's statement, which would give subsidies to people who have income higher than what is allowed.

I like your idea, FLM2, where you said, "This can be done very simply by using prior year income as the determining factor for subsidies and having exceptions allowed for those whose income will be lower in the year of the subsidy due to job loss or change in status. Those exceptions would be the only ones needing audit or being subject to clawback."

That would eliminate the crystal ball predictions of future income, and would greatly reduce clawbacks. Essentially, that is how Medicaid has qualified people. They look at last year's income, but also at this month's income. The only deal is that they have to re-evaluate often.

 

[FLM2]

However, that is not what Rep Pascrell said. He said, "Why should individuals be punished if they got a bump in salary? To me, this was not the ACA I voted on."

I agree that subsidy eligibility should not require a crystal ball to predict future income. However, that is a different concept than Pascrell's statement, which would give subsidies to people who have income higher than what is allowed.

I like your idea, FLM2, where you said, "This can be done very simply by using prior year income as the determining factor for subsidies and having exceptions allowed for those whose income will be lower in the year of the subsidy due to job loss or change in status. Those exceptions would be the only ones needing audit or being subject to clawback."

That would eliminate the crystal ball predictions of future income, and would greatly reduce clawbacks. Essentially, that is how Medicaid has qualified people. They look at last year's income, but also at this month's income. The only deal is that they have to re-evaluate often.

Ann, I don't read your interpretation into that short quote from Pascrell but we agree on the important part, that basing a subsidy on next year's income just makes no sense and creates a real problem for everyone.

 

[houcoogster]

Originally Posted by Yagents View Post

This one's a doozy (LMAO):

News from The Associated Press

Rep. Bill Pascrell, D-N.J., said in an interview that he disagrees with making people pay back part of their premium subsidy. That would happen if someone made more money during the year and failed to report it to HealthCare.gov.

"Why should individuals be punished if they got a bump in salary?" said Pascrell. "To me, this was not the ACA I voted on."

Sure it is............you read it.......right?
What a dip.......what is in the water up there?
----------------------------
Rep Pascrell is dead on, 100% right. Clawback, for me, is one of the worst aspects of the ACA and should be eliminated. This can be done very simply by using prior year income as the determining factor for subsidies and having exceptions allowed for those whose income will be lower in the year of the subsidy due to job loss or change in status. Those exceptions would be the only ones needing audit or being subject to clawback.

The presence of clawback makes it difficult for me to make any recommendation to a client about a subsidized plan without spending 5 minutes talking about what could happen. It is also prone to fraud as it is so easy to put in a number that is incorrect just to maximize a subsidy.

Rep Pascrell is 100% dead wrong and so are you. If you wrote more than 20 subsidy apps you would understand why. The current system is the right system. Hc.gov tells you if you have a change in income to notify them. If people can't read or want to lie or they don't have a good agent thats too bad.

 

[FLM2]

Rep Pascrell is 100% dead wrong and so are you. If you wrote more than 20 subsidy apps you would understand why. The current system is the right system. Hc.gov tells you if you have a change in income to notify them. If people can't read or want to lie or they don't have a good agent thats too bad.

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I don't need to write 20 exchange applications to know a bad law when I see it and this aspect is awful.

It makes no sense whatsoever and will cost the IRS tons of money to track down everyone whose income changed and piss off lots of people who get a tax bill plus interest and penalty because their income changed in mid-year and weren't thinking it would change anything.

I can't expect you to understand this because your vision is as long as your nose.

 

[Yagents]

Wait until Mar / Apr when your clients file taxes, and can't file 1040EZ. Then, and only then, will O'care be in full swing as this new facet of the law hits everyone in the face.

Me in Nov: "Mr client, what did your income end up being for 14'?"
Client: "Don't know yet, haven't filed taxes yet"
Me: Well, be prepared for a "clawback" of some tax credits (or refund)
Client: But, I can't afford to pay back money.
Me: Doesn't matter.......Now, tell me what you expect to make in 2015.

 

[houcoogster]

Wait until Mar / Apr when your clients file taxes, and can't file 1040EZ. Then, and only then, will O'care be in full swing as this new facet of the law hits everyone in the face.

Me in Nov: "Mr client, what did your income end up being for 14'?"
Client: "Don't know yet, haven't filed taxes yet"
Me: Well, be prepared for a "clawback" of some tax credits (or refund)
Client: But, I can't afford to pay back money.
Me: Doesn't matter.......Now, tell me what you expect to make in 2015.

Why didn't you explain that aspect when you wrote him. And why didn't Mr. Client notify the marketplace when their income changed?

 

[Yagents]

I did tell them, and reread what I wrote.......they don't know their 14' income tally yet.

 

[kgmom219]

Most people on here are self employed...do you know your income, within $5K for 2014? What if I get a 50 person group for 12/1? That's a $15K annual increase in income. I submit my app before then. So I call hc.gov in Dec. Yeah. That's going to work. I call in May to fiix it. On the off chance they DO fix it correctly, I have 6 months of subsidy to payback the NEXT year. Then in November, I do my 2016 app, assuming the 50 person group. I lose it after Dec 15th. So then I am not getting a subsidy when ACA says I am entitled to one. Using projected income is going to create one PITA after another.

SSA/Medicare uses tax returns 1-2 years in arrears to determine the Part B premium. There is an appeals process in place for income/life changes. IMO, long term, that is the solution that will work. That's 5+ years and a presidential election away. We shall see what this looks like in 2020

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I did tell them, and reread what I wrote.......they don't know their 14' income tally yet.

Buy a crystal ball for your office.....