Obamacare

What Will Happen to Health Insurance in 2019?

December 27, 2017 By Jackie Cohen 8 Comments

About 4 million people who currently have coverage may lose their health insurance in 2019, and as many as 17 million people would become uninsured by 2027.

That statistic comes from the U.S. Congressional Budget Office’s analysis of the Tax and Jobs Act that President Donald Trump signed into law last week.

The law eliminates the penalty for not having insurance, starting in 2019.

Health Insurance in 2019

This measure follows the Republicans’ failure to repeal the Affordable Care Act, otherwise known as Obamacare.

Obamacare had required consumers to obtain insurance or pay a penalty unless they qualified for certain limited exceptions.

The penalty for not having insurance in 2018 remains what it was in previous years: for each adult, $695 or $2.5% of household income in excess of tax filing thresholds, whichever is higher.

Who Bought Coverage

While data on the outcome of the latest open enrollment has yet to be released, for the prior year’s open enrollment (for 2017 coverage), about 7% of Americans government-sponsored via government-sponsored individual insurance marketplaces, according to the Kaiser Family Foundation.

Also that year, about 9% of Americans went without insurance, and the rest obtained coverage through employers, Medicare or Medicaid.

The penalty for not having insurance was intended to stabilize premiums in a way that allowed people with pre-existing health conditions to obtain coverage without having to pay exorbitant premiums.

Watch What Happens to Premiums

Those exorbitant premiums are expected to return as a result of the Obamacare repeal: Without the requirement to have coverage, healthy people may go without insurance, depriving the insurers of the funds to help cover those with pre-existing conditions.

About 85% of those who participated in the health insurance coverage marketplaces under Obamacare qualified for some form of subsidies — and they are expected to not feel the brunt of the premium increases in 2019 and beyond.

However, people who make too much money to qualify for subsidies of their health insurance might not be able to afford coverage.

The prospect of a less predictable customer pool might make some insurers decide to stop offering individual consumer health insurance, which in turn will result in fewer choices for consumers.

Children’s Health Insurance Program

What might exacerbate the situation is resulting from another legislative snafu: 9 million may lose coverage due to the expiration of funding for the Children’s Health Insurance program.

Whether lawmakers might rescue that program remains to be seen, as the video beneath this post shows.

Readers, what changes have you seen so far in your own health insurance?

Health Insurance May Affect Your Tax Refund

February 1, 2015 By Lilian Nwa 3 Comments

The Affordable Care Act, popularly known as ObamaCare, strives to ensure that all Americans are covered by health insurance. Part of the impetus for the passage of the ACA is that Americans continue to spend significantly more on healthcare than other industrialized nations, partially due to the fact that after Mexico, the U.S. is the fattest country in the world. Unsurprisingly, Americans suffer from the diseases associated with obesity such as diabetes, high cholesterol, high blood pressure and other chronic diseases at rates higher than seen in other countries, which is felt by our healthcare system. Regularly visiting a physician, as provided for under the ACA through health insurance coverage, should prevent the worsening of chronic diseases and might enable physicians to treat problems before they become unruly, chronic and expensive illnesses.

To ensure that the ACA is affordable and covers all Americans, most people must have health insurance or pay a fine (from $95 per person up to 1 percent of household income, whichever is greater for the year 2014), though Americans making less than four times the Federal Poverty Guideline are allowed to reduce their monthly insurance premiums with subsidies granted by the federal government. Other Americans might qualify for exemptions, allowing them to avoid fees and fines altogether; however, special qualifications must be met in order for them to avoid these payments.

For all Americans, however, this tax filing season is the first instance when people will have to “deal with the Affordable Care Act” and unfortunately, this might result in lower tax refunds. To receive the subsidy, the ACA requires that individuals estimate their future income. The IRS then sends this information to insurance companies, which will subsequently reduce the premiums for eligible households.

But the IRS may overpay or underpay insurance companies based on these estimates, a problem that will be ameliorated when those who underestimated their income receive less in the form of a tax refund. Some tax filers might even have to return “hundreds or thousands of dollars back o the IRS [though] there is a $2,500 cap on paychecks.” The number of individuals who have to do so, however, is likely very small, but to determine appropriate subsidy amounts, Americans must complete Tax Form 8962. For those who might owe a penalty, Form 8965 will determine the amount of the fine.

Alternatively, those Americans who have insurance coverage without any subsidies simply need to check a box on their 1040 tax form, indicating that they are covered by an insurance policy. Indeed, in a recent statement, Jacob Lew, Treasury Secretary for the Obama Administration, reminded citizens, “For the vast majority of Americans, tax filing under the Affordable Care Act will be as simple as checking a box…A fraction of taxpayers will take different steps” such as claiming an exemption and yet “A smaller fraction…will pay a fee if they made a choice to not obtain coverage they could afford.”

Don’t forget the last day to sign up for health insurance this year is February 15.

(Photo courtesy of Phillip Ingham)

When Is the Last Day to Sign up for Health Insurance 2015?

January 27, 2015 By Lilian Nwa 1 Comment

The Patient Protection and Affordable Care Act (PPACA), known simply as the Affordable Care Act (ACA) or “ObamaCare” was signed into law on Mar. 23, 2010, and represents the “most significant regulatory overhaul” of the U.S. healthcare system since the introduction of Medicare and Medicaid in 1965.

The purpose of the ACA is to increase the quality and affordability of health insurance. By expanding individual insurance coverage, the government hopes to reduce the costs of healthcare for itself and all Americans.

On June 28, 2012, after a challenge from Republicans, the United States Supreme Court upheld the constitutionality of the ACA; however, states cannot be forced to participate in the ACA’s Medicaid expansion program. Regardless, as of May 2014, approximately 20 million Americans are covered under the new law and the percentage of uninsured Americans dropped to 13.4% from 18% in May 2013.

When is the last day to sign up for health insurance?

Currently, if you have not signed up for coverage, the last day to sign up for health insurance is February 15, 2015. If you do enroll by this date, coverage can begin as soon as March 1. However, after this date, the only option for late enrollment or changing the specifics of your plan is if you qualify for a Special Enrollment Period. According to HealthCare.gov, the only individuals who will qualify for this enrollment period are those who have experienced “certain life events that involve a change in family status.” Such life events could be marriage, the birth of a child or the loss of health coverage. If such events occur, you qualify for a special enrollment period of 60 days following the event, whereas job-based plans must provide a special enrollment period of 30 days.

What happens if I don’t sign up for health care?

If you can afford health insurance, but choose not to purchase coverage, you must pay a fee sometimes called the “individual responsibility payment” or “individual mandate.” According to the following link at Healthcare.gov, lack of coverage means you will pay the higher of two amounts: 2 percent of your yearly household income or $325 per person for the year ($162.50 per child under 18). Detailed explanations for the maximum penalty in each case can be found by following the link highlighted above.

If you choose not to purchase coverage, you can also apply for exemptions from payment; however, there are specific requirements in order to qualify. For example, your income must be too low to file a tax return or you may qualify for a “hardship exemption.” More information can be found by following this link.

You should note, however, that if you are applying to Medicaid or the Children’s Health Insurance Program (CHIP), these programs provide free or low-cost coverage to Americans with limited incomes and as such, and these programs have no deadlines. Additionally, many states have expanded Medicaid enabling more individuals to qualify, so you should contact Healthcare.gov or call 1-800-318-2596 to speak with a representative if you would like to learn more about your state’s healthcare marketplace or for all other questions. For individuals and their families, representatives are available 24 hours a day, 7 days a week except on Memorial Day, July 4th, and Labor Day.

For more helpful tips, information about dental coverage, or to learn how to choose a plan, visit the following link at Healthcare.gov and scroll down to the bottom of the page where you will see a list of options under “Take action now.”

For those who currently have healthcare through the ACA government website or state run exchanges, you should be getting your 2014 tax form soon if you received a subsidy.

Obamacare Health IRS Form Should Soon be Coming in the Mail

January 12, 2015 By Jeffrey Strain Leave a Comment

Administration says form 1095-A will be arriving in mail for taxes

With the new year, you should start to get tax forms in the mail. There is a new one you should be on the lookout for if you were one of the millions of people who signed up under the Affordable Care Act (Obamacare) and received subsidies for your insurance. If you did, you should be receiving a new form in the mail for this tax season.

The form is called form 1095-A, and in many respects, it’s like a W2 form for health care insurance. You’ll need this form to fill out your 2014 taxes, and the administration announced it has started to send them out to people. Keep an eye out for it in the mail, and be sure not to accidentally throw it away as junk mail. There was worry earlier that these forms could delay people getting their tax refunds this year.

The 1095-A is a form for those consumers who, as part of Obamacare or their state’s health exchange, received tax credits for the insurance they purchased. The form will show the amount of money the government subsidized the insurance premium you chose, and the information is taken from what you input into the system when applying for the health coverage. It’s important to check and make sure the numbers are correct, and you’ll need to report this number to the Internal Revenue Service (IRS) when you file your taxes. If you do see a mistake on the form, contact HealthCare.gov or your particular state insurance exchange to resolve any discrpencies.

Since this is the first year that those who have purchased subsidized health insurance will be receiving this form, government officials are concerned many people will not know what the form is, or ignore it since they have never needed it when filing their taxes in the past. They want to make clear that the information on this form is needed for filing your taxes, so it’s important to make sure to open it when it arrives. The form itself doesn’t need to be filed with your taxes.

The information on form The 1095-A will be needed to fill out form 8962, which will be filed with your taxes. Either you, or your tax preparer, will need to fill out form 8962. This form shows whether you received the correct subsidy amount you were entitled to under the law. The amount you’re entitled to depends on the size of your household, your income and the cost of health insurance in your area. If you received too much of a subsidy, the IRS will automatically reduce the amount you get back on your tax return. This might happen if you received a raise or your income increased in 2014 beyond what you put in when filing for health care, and you failed to report this income increase to your state insurance exchange or HealthCare.gov. On the other hand, if your income was less than what you estimated it would be when you signed up, the IRS will increase your refund.

Tax Form 1095-A May Delay ObamaCare Recipients Tax Refunds

August 30, 2014 By Kal Kurdi 13 Comments

Millions of Americans may experience a delay in receiving their tax refunds next year. If you’re among those who have applied for, and successfully received healthcare benefits through President Obama’s Affordable Care Act initiative, there’s a new form you’re going to have to get from the insurance exchange before you can even file for your 2014 tax return.

This new form is called the 1095-A, which you can take a look at here. The form will list all of the individuals in the household who receive the benefits and how much the government has spent subsidizing their premiums. The forms are to be issued by the same agency that was heading the HealthCare.gov initiative, whose debacle in launching the site last fall has not yet been forgotten.

The Health and Human Services Department (HHSD) had, at that time, launched the website which only riddled most applicants with various errors. It was estimated that only 1% of the interested parties were able to successfully register, but even those who got through failed to have a smooth registration process. Later on, insurance companies were stating that most of the initial applications were missing information.

The lack of confidence in the HHSD primarily stems from that. Justifiably, some tax professionals are concerned that they simply won’t be able to have all the forms out and in the hands of the millions of Americans by the January 31st deadline.

Although it may seem a week or two delay won’t amount to much, it in fact could put a serious strain on the families who depend on their tax returns to fill any financial voids. President Obama’s administration says that the task is on track, but refuses to provide any additional details.

States who operate their own health insurance marketplaces are also required to issue their own forms to those receiving their benefits. Though the biggest responsibility falls on the shoulders of the HHSD to get the forms to the individuals residing in the 36 states that it serves. The fact that they’re going to have to manage that and the 2015 registrations simultaneously may in fact delay the 1095-A’s timely delivery.

Although some seem confident the forms will arrive on time, it cannot be ignored there’s a real possibility of a negative outcome. Unfortunately, all recipients can do is idly wait for that day to arrive and hope the mess from last fall was a one-time incident.

Can a Company Prevent Free Birth Control Access? The Supreme Court Will Decide

June 14, 2014 By Jeffrey Strain 10 Comments

The Supreme Court will decide if for-profit companies like Hobby Lobby can exempt birth control from the Affordable Care Act on religious grounds

There are a couple of big cases before the Supreme Court which have the potential to have a major impact on the finances of women and families. In two cases before the court, Sebelius vs Hobby Lobby Stores and Conestoga Wood Specialties Corp vs Sebelius, the justices will have to decide whether for-profit companies must abide by the Affordable Care Act mandate to provide no-cost prescription contraception as part of most health insurance plans offered.

As part of the Affordable Care Act, most insurance plans must provide certain preventive care services for free to beneficiaries. The Obama administration included all FDA-approved contraceptives for women as part of these preventative services. At issue is whether or not for-profit companies should have to provide contraceptives to women if it goes against the religious beliefs of the owners of those companies.

While some non-profit and religious organizations are exempt from this mandate, the law doesn’t allow for-profit companies to be exempt. The owners of Conestoga Wood and Hobby Lobby (both for-profit companies) say they have no problem offering birth control to women, but they do have issue with certain types of birth control. They’re specifically against providing emergency contraceptives such as Plan B and Ella, which can prevent pregnancy when taken after a sperm and egg have united. They argue their religious freedom is being violated because they view this specific type of birth control as an abortion. Since emergency contraceptives are able to prevent a fertilized egg from implanting into the uterus of a women, they consider using them the same as a very early stage abortion.

While the two companies’ owners consider this abortion, the majority of the medical and scientific communities don’t. As part of the lawsuit, ten medical groups, including the American College of Obstetricians and Gynecologists, submitted a brief that states, “There is a scientific distinction between a contraceptive and an abortifacient and the scientific record demonstrates that none of the FDA-approved contraceptives covered by the Mandate are abortifacients.” They hold this view since the medical and scientific communities usually define pregnancy beginning at the time a fertilized egg implants in a woman’s uterus. This is the conflict which the Supreme Court must decide.

If the court rules in favor of Conestoga Wood and Hobby Lobby, and for-profit companies can decide to opt-out of providing no-cost birth control, it could have big financial consequences for women and families. For those women who can afford birth control, it would simply mean paying more out of pocket for this service. For those who can’t afford birth control on their own, however, it could mean an unwanted pregnancy and the huge cost of a raising a baby for the entire family. While the financial implications aren’t the main focus of the debate, they certainly will come into play for a large number of families if the for-profit companies win the case.

Arguments for both sides have already been made to the Supreme Court, and a decision on these cases is expected later this month.

(Photo courtesy of Nicholas Eckhart)