New from the IRS:
Publication 5187:
Health Care Law: What’s New for Individuals & Families
Available at www.irs.gov/pub/irs-pdf/p5187.pdf
Category Archives: News and Updates
2014 Federal Poverty Guidelines Released
Under ACA, eligibility for Medicaid and premium-reduction subsidies for exchange policies is governed by the poverty guidelines for the policy year. The 2014 guidelines are now available and can be viewed at: http://familiesusa.org/product/federal-poverty-guidelines
In the Medicaid expansion states, individuals and families who fall under 133% of the poverty line will receive coverage through Medicaid. Those whose incomes are between 133% and 400% are eligible for subsidies and/or a tax credit when purchasing insurance through an exchange.
In states that have not expanded Medicaid, individuals and families are eligible to purchase subsidized insurance from an exchange so long as their anticipated income is at or above the 100% poverty level.
If a taxpayer is approved to receive a subsidy by an exchange, but their total income for the year as reported on their 2014 return falls below the 100% level, their tax credit will be computed as the value that would apply if their income was exactly 100% of the FPL. Continue reading
Worth reading
A good overview of the interaction between premiums, age, and income on the exchange– and some of the factors that typically are left out in most news reporting:
The dirty secrets behind Boehner’s ‘spiking’ Obamacare premiums
By Michael Hiltzik – Los Angeles Times – November 25, 2013
HealthSherpa Web site
Does navigating your government-created health exchange web site give you a headache?
Here’s a quick online tool to find the health care offerings in your area, including a tool to quickly estimate subsidies:
http://www.thehealthsherpa.com/
This is a free tool created using public databases. No login required — all information can be quickly entered on the home page, with results appearing as the the data is entered.
(Created as a public service by three young and capable San Francisco-based computer technicians – see http://www.thehealthsherpa.com/about to learn more about them)
Today’s number: 17
17% of potentially eligible Americans visited Affordable Care Act marketplaces in October, according to a survey by the Commonwealth Fund. Of those visitors, 20% were young people between the ages of 19-29, and 20% of those who visited actually enrolled in a plan. 60% of survey respondents were aware of aware of the purpose of the health care exchanges; of those that did not enroll, 37% cited technical problems with the exchange web sites as the reason for not enrolling.
17 million individuals will qualify for insurance subsidies, according to an analysis by the Kaiser Family Foundation. This number represents nearly 6 in 10 Americans eligible to participate in the ACA health insurance marketplaces. To receive a subsidy through the ACA, individuals must earn between 100-400% of the federal poverty line. Most of the individuals qualifying for subsidies reside in Texas, California, and Florida.
Insurance cancelled? Don’t blame Obama or the ACA, blame America’s insurance companies
Insurance cancelled? Don’t blame Obama or the ACA, blame America’s insurance companies
By Juan Williams , Published November 05, 2013, FoxNews.com
Anthem California Provider Lists
Finding Anthem’s provider lists for California is something of a treasure hunt — you can’t do it from the home page. But, nonetheless, I found it (and no, I don’t know if these will be updated to include more providers or hospitals in the near future):
Select your plan network from the list below:
Pathway X and Pathway PPO – ON & OFF Individual Exchange – PPO Network
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Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, Yuba Counties |
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Marin, Napa, Solano, Sonoma Counties |
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El Dorado, Placer, Sacramento, Yolo Counties |
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Contra Costa County |
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Alameda County |
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Santa Clara County |
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San Mateo County |
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Monterey, San Benito, Santa Cruz Counties |
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Mariposa, Merced, San Joaquin, Stanislaus, Tulare Counties |
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Fresno, Kings, Madera Counties |
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San Luis Obispo, Santa Barbara, Ventura Counties |
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Imperial, Inyo, Mono Counties |
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Kern County |
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Riverside, San Bernardino Counties |
Pathway X and Pathway Tiered – ON & OFF Individual Exchange – EPO Tiered Network
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Los Angeles County |
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Orange County |
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San Diego County |
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San Francisco County |
Pathway X and Pathway HMO – ON & OFF Individual Exchange – HMO Network
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El Dorado, Placer, Sacramento, Yolo Counties |
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Fresno, Kings, Madera Counties |
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Los Angeles County |
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Orange County |
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Riverside, San Bernardino Counties |
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San Diego County |
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Santa Clara County |
What happens if Healthcare.gov doesn’t get fixed?
What Happens if the Healthcare.gov Website Remains Non-Functional? Here’s a great article that explains the likely options to bridge the problems caused by technical glitches:
A website that works
Frustrated with Healthcare.gov? It turns out that there’s another web site where the federal government stores data about the plans from the states. It’s not fancy, but it works.
Here’s a link:
https://data.healthcare.gov/dataset/QHP-Individual-Medical-Landscape/ba45-xusy
The ACA still doesn’t exist in North Carolina
In this state, you have only two options if you want an ACA-compliant health insurance policy: Blue Cross/Blue Shield (“BCBS”) and Coventry.
Correction: If you live in one of the 39 counties that Coventry covers you have two options. In the other 61 counties in N.C., you have only one option: BCBS.
But you can’t get a subsidy through BCBS because their website can’t connect to healthcare.gov, and I’ve been told you can’t even get a quote from Coventry. I’ve heard that some people have managed to set up an account at healthcare.gov but I’m not one of the lucky few, and I’ve tried maybe 20 times by now.
Continue reading
An Ad Hoc Guide to the Affordable Care Act 