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Mon Nov 19, 2012, 05:42 PM

 

Question about the ACA

Would people who qualify for Medicaid, but their state refuses to expand it; would they still be required to buy private insurance?


I cant afford up to 8% of my income. Im under the poverty level right now and I could never find 8% of my meager pay to buy private insurance. I will also not be able to pay the tax (up to 2.5% eventually). I would literally have to cut out my transportation costs, and/or food or a utility bill every month to cover the difference.

This has been bothering me for some time now as I realize many states will simply refuse to expand their Medicaid programs.

Will the millions of people eligible under Medicaid still be forced to buy private insurance they cant afford if states refuse to expand this vital program?


24 replies, 1477 views

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Replies to this discussion thread
Arrow 24 replies Author Time Post
Reply Question about the ACA (Original post)
argiel1234 Nov 2012 OP
still_one Nov 2012 #1
argiel1234 Nov 2012 #2
PoliticAverse Nov 2012 #3
argiel1234 Nov 2012 #6
PoliticAverse Nov 2012 #7
argiel1234 Nov 2012 #9
PoliticAverse Nov 2012 #11
riderinthestorm Nov 2012 #4
argiel1234 Nov 2012 #5
PoliticAverse Nov 2012 #8
riderinthestorm Nov 2012 #10
argiel1234 Nov 2012 #13
PoliticAverse Nov 2012 #17
riderinthestorm Nov 2012 #21
argiel1234 Nov 2012 #22
argiel1234 Nov 2012 #12
PoliticAverse Nov 2012 #15
argiel1234 Nov 2012 #18
argiel1234 Nov 2012 #20
PoliticAverse Nov 2012 #23
rgbecker Nov 2012 #14
argiel1234 Nov 2012 #16
rgbecker Nov 2012 #24
Dubster Nov 2012 #19


Response to still_one (Reply #1)

Mon Nov 19, 2012, 05:55 PM

2. thanks, but this doesnt answer my question

 

Medicaid is administered through the states and many(mine included) will not expand Medicaid even if we are eligible. Will we still be forced to buy insurance or pay the penalty even though we qualify for medicaid but wont receive it due to states refusing to expand the program?

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Response to argiel1234 (Original post)

Mon Nov 19, 2012, 05:57 PM

3. If you are under the federal poverty level the answer is no, you are not required to buy insurance.

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Response to PoliticAverse (Reply #3)

Mon Nov 19, 2012, 06:04 PM

6. that doesnt answer if we will be required to pay the tax/fine/whatever people call it.

 

Ultimately it will be 2.5% of peoples income.

I dont see anything addressed in there for people who qualify for Medicaid but their state refuses to expand it.

Would we be exepmt from both the requirement to buy private insurance AND the tax? Since we quality for Medicaid, why should be forced to pay the tax is states refuse to expand?

Also its what is actually what is happening. Many states are refusing to expand the Medicaid program outright


Whats going to happen to those millions of people?

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Response to argiel1234 (Reply #6)

Mon Nov 19, 2012, 06:13 PM

7. Yes it does answer. You only are assessed the penalty if you are required to be insured but aren't.

Since you won't be required to buy insurance you won't be assessed any penalty for not doing so.

What will happen to those millions of people ? The same thing that is happening to them now, they can't afford
insurance and aren't eligible for Medicaid.

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Response to PoliticAverse (Reply #7)

Mon Nov 19, 2012, 06:19 PM

9. my income is 10,800 roughly, that puts me in the category of poverty

 

but still required to buy insurance or pay the tax, even though Im eligible for Medicaid


Im seeing a huge hole in this law thats going to ensnare millions of people who are eligible for medicaid but states refuse to enroll them. They would still be required to buy insurance(up to 8% of their income) or pay 2.5% tax and STILL not have insurance.


I just realized this after looking into the law more closely. This is a large problem because many states refuse to expand the medicaid program regardless of income


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Response to argiel1234 (Reply #9)

Mon Nov 19, 2012, 06:23 PM

11. 8% of $10,800 is = $864. You won't find an insurance policy for that amount,

and so will not be required to spend more to buy one or pay any penalty.

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Response to argiel1234 (Original post)

Mon Nov 19, 2012, 05:59 PM

4. Yes, everyone will be mandated to pay for insurance BUT if you fall below a certain poverty line

your premium will be subsidized.

I don't know the specific details on how that's going to work but hopefully someone will come onto this thread and help out. This was a quick response to get the thread kicked for more eyes on your question....

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Response to riderinthestorm (Reply #4)

Mon Nov 19, 2012, 06:00 PM

5. thank you

 

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Response to riderinthestorm (Reply #4)

Mon Nov 19, 2012, 06:17 PM

8. Since the op is below the federal poverty level the op's premium won't be subsidized.

The ACA intended such people would be covered by Medicaid but since the Supreme Court overturned
the all-or-nothing requirement for states to participate in the ACA Medicaid expansion people below the FPL
will simply be left without any coverage (they won't be required to buy insurance and won't pay any penalty
since the insurance premiums would exceed 8% of their income).


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Response to PoliticAverse (Reply #8)

Mon Nov 19, 2012, 06:22 PM

10. Thanks. Then Argiel's correct that there's a big gap in the ACA as currently structured

and a fair number of poor people are going to be left out.

Bummer.



Thanks for the clarification though.

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Response to riderinthestorm (Reply #10)

Mon Nov 19, 2012, 06:37 PM

13. thank you for the response

 

say someone makes $15,000 a year, which by any measure is close to poverty. They are going to be required by law to either pay 2.5% of their income in a new tax and STILL not have health insurance, OR pay up to 8% of their income to buy private insurance with high co-pays and high deductibles that they might not even be able to afford to use.



Im sorry but this is beginning to anger me.


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Response to argiel1234 (Reply #13)

Mon Nov 19, 2012, 06:44 PM

17. You don't have to "pay 2.5% or 8%". If the insurance available costs more than 8% of your income

you don't have to buy the insurance and you do not have to pay any penalty for not doing so.

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Response to PoliticAverse (Reply #17)

Mon Nov 19, 2012, 06:51 PM

21. And s/he won't get insurance either. It will simply be unavailable to them.

I think that's the point of argiel's thread if I understand it correctly.

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Response to riderinthestorm (Reply #21)

Mon Nov 19, 2012, 06:56 PM

22. yes that is the whole point. Thank you for clarifying this

 

Im now upset about this as this law was not thought out very well at all, especially considering leaving it up to repuke governors and the SC was always going to play out.


This WILL anger many millions of people who live paycheck to paycheck and will either be hit with a new 2.5% regressive tax increase or pay for garbage insurance.


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Response to PoliticAverse (Reply #8)

Mon Nov 19, 2012, 06:25 PM

12. The poverty guideline and the law as it is written are different

 

the ACA states people who legally are not required to file a tax return(under 9,300 or so) The Federal Poverty is 11,000 roughly. I may make around 12,000 by 2014 if I get my measly 25 cent raises, which still entitles me to Food Stamps and houseing assistance, but puts me in the category of paying 2.5% or 8% of my income.


Someone making 12k a year does not have 2.5% or 8% of their income to piss away.


This law needs to be amended or many millions are going to be very very angry when they realize how fucked they are.

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Response to argiel1234 (Reply #12)

Mon Nov 19, 2012, 06:38 PM

15. I think you misunderstand a key point, you don't "have to pay 2.5% or 8% of your income"...

It's that if the cheapest insurance on the exchange that meets the government's minimum requirement would
cost more than 8% of your income you neither have buy it nor pay any penalty for not buying it.

Suppose your income is $12,000. 8% of that is $960. It's unlikely there will be insurance offered that meets the
Federal Government requirements for that price. Suppose for example the cheapest insurance offered on the exchange
is $2,500. This exceeds 8% of your income so you don't have to buy it and you don't have to pay any penalty for not
doing so.


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Response to PoliticAverse (Reply #15)

Mon Nov 19, 2012, 06:47 PM

18. The problem is there are no guidelines on how companies price their products.

 

There is nothing stopping a company from charging $950, and then having a 10k deductible and high co-pays.

$950 to someone who makes 12k a year is devastating.

Hell, 2.5% of total income to someone who makes 12k is devastating and would be a huge tax increase

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Response to argiel1234 (Reply #18)

Mon Nov 19, 2012, 06:49 PM

20. edit

 

this law should have been thought out better

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Response to argiel1234 (Reply #20)

Mon Nov 19, 2012, 06:57 PM

23. The attempt to get very low income people included under Medicaid was something that

did backfire when the Supreme Court gave states the option to opt-out without penalty.

In the end though only a few states will probably opt-out of the Medicaid expansion.

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Response to argiel1234 (Original post)

Mon Nov 19, 2012, 06:38 PM

14. I hope you check back and tell us what happens in 2014.

If I were Governor Romney I'd bet you $10,000 that if you only have an income of $12,000 you won't be required to buy insurance or pay a penalty.

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Response to rgbecker (Reply #14)

Mon Nov 19, 2012, 06:43 PM

16. 12,000 is above the federal poverty level

 

It would require a new tax from me of 2.5% of my income, OR I would have to pay up to 8% of my income to buy a private insurance plan which I may not be able to afford to use.


This is according to the law that was listed in links above.



Many millions are going to be very angry when they see this.

Perhaps this should have been thought out more before being implemented.

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Response to argiel1234 (Original post)

Mon Nov 19, 2012, 06:48 PM

19. Spam deleted by gkhouston (MIR Team)

 

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