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Thu Jan 31, 2013, 05:50 PM

Kids of the Working Poor to Remain Uninsured Under "Health Care Reform"

Looks like the working poor just got screwed again. A portion of the new law which was supposed to limit the out of pocket for a family's employer sponsored insurance to less that 9.5% (a huge chunk if you are skating on the edge of poverty) is now being interpreted by the IRS as limiting the family's out of pocket to 9.5% of the income for the worker's insurance only. This is a big win/win for both health insurers (who like to insure workers, because, hey, they are healthy enough to work, so there can't be much wrong with them) and employers (who want their employees to get well as fast as possible so they can get back to work). However, it means that if your employer offers family coverage that will eat up 20% of your paycheck and you think you can't live off 80% of what you used to bring home, the government is not going to help your spouse or kids get insurance. In some cases, it will mean that the kids will no longer be eligible for SCHIP--meaning that the new law is costing them insurance.

The IRS has graciously decided not to charge the children of the working poor a penalty for being unable to afford insurance. Aw, how sweet of them.

At the risk of offending administration supporters, I smell a big, fat carrot/rat. As in health care is still being used as a carrot to get voters to the polls. The working poor (whose kids will be unable to get check ups, get asthma treatment etc.) will be told "It isn't our fault. Our hands are tied. Congress has to fix this loophole in the law. But the Republican House won't."

Which begs the question, if the IRS can unilaterally decide not to tax the kids who can not afford insurance, why can't the IRS decide that the 9.5% was supposed to cover both workers and their kids?

30 million people will remain uninsured in 2016---and many of them will be children. Stop playing politics with the health of our kids! Declare a national healthcare emergency, open Medicare up to all children. Then stand back and watch how quickly the privates drop their rates for coverage of children.

http://www.nytimes.com/2013/01/31/us/politics/irs-to-base-insurance-affordability-on-single-coverage.html?ref=health

10 replies, 1232 views

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Arrow 10 replies Author Time Post
Reply Kids of the Working Poor to Remain Uninsured Under "Health Care Reform" (Original post)
McCamy Taylor Jan 2013 OP
Mnemosyne Jan 2013 #1
rhett o rick Jan 2013 #2
JaneyVee Jan 2013 #3
Demo_Chris Jan 2013 #4
antigop Jan 2013 #5
ProSense Jan 2013 #6
LisaLynne Feb 2013 #9
annabanana Jan 2013 #7
Demo_Chris Feb 2013 #8
kenny blankenship Feb 2013 #10

Response to McCamy Taylor (Original post)

Thu Jan 31, 2013, 06:27 PM

1. Single payer now. Thanks McCamy! nt

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Response to McCamy Taylor (Original post)

Thu Jan 31, 2013, 07:31 PM

2. I am not sure but I think the president can write an executive order

associated with this bill (unless there is a time period involved) to state his interpretation.

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Response to McCamy Taylor (Original post)

Thu Jan 31, 2013, 07:43 PM

3. That 9.5% is at 400% of Federal poverty level which would mean a family of 4 at $92,000.

A single person would be $45,000.

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Response to McCamy Taylor (Original post)

Thu Jan 31, 2013, 08:44 PM

4. kick

 

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Response to McCamy Taylor (Original post)

Thu Jan 31, 2013, 08:52 PM

5. It's not just kids...it's spouses, too...

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Response to McCamy Taylor (Original post)

Thu Jan 31, 2013, 09:21 PM

6. This is not the final rule, and

it likely needs to be clarified.

Fact Sheet on Proposed Affordable Care Act Regulations
http://www.democraticunderground.com/10022291387

Still, the NY Times article and other reports appear to be making incomplete assumptions

In 2012, according to an annual survey by the Kaiser Family Foundation, total premiums for employer-sponsored health insurance averaged $5,615 a year for single coverage and $15,745 for family coverage. The employee’s share of the premium averaged $951 for individual coverage and more than four times as much, $4,316, for family coverage.

Under the I.R.S. rule, such costs would be considered affordable for a family making $35,000 a year, even though the family would have to spend 12 percent of its income for full coverage under the employer’s plan.

Is this a single-income family? If this is based on two incomes, what would prevent either parent from covering both kids (assuming neither parent earns more than $26,000)?

The Medicaid subsidies are up to 400 percent of FPL (about $90,000 for a family of four), and a family of three qualifies for full Medicaid up to $26,344.

A key element of the Affordable Care Act (ACA) is the expansion of Medicaid to nearly all individuals with incomes up to 138 percent of the federal poverty level (FPL) ($15,415 for an individual; $26,344 for a family of three in 2012) in 2014. Medicaid currently provides health coverage for over 60 million individuals, including 1 in 4 children, but low parent eligibility levels and restrictions in eligibility for other adults mean that many low income individuals remain uninsured. The ACA expands coverage by setting a national Medicaid eligibility floor for nearly all groups. By 2016, Medicaid, along with the Children’s Health Insurance Program (CHIP), will cover an additional 17 million individuals, mostly low-income adults, leading to a significant reduction in the number of uninsured people.

http://www.democraticunderground.com/10022159929

The assumptions about children are also wrong:

<...>

Who qualifies for CHIP?

Every state operates a CHIP, although most states have unique names for their programs like Child Health Plus (New York), Healthy Families (California), and Hoosier Healthwise (Indiana). In several states, CHIP and Medicaid are combined into one program.

Here are some CHIP basics:

  • Basic eligibility for CHIP: Children up to age 19 in families with incomes up to $45,000 per year (for a family of four) are likely to be eligible for coverage. In many states, children in families with higher incomes can also qualify.

  • Eligibility and pregnancy: Pregnant women may be eligible for CHIP. Coverage for expectant mothers generally includes lab testing and labor and delivery costs, and at least 60 days of care after delivery.

  • Citizenship and immigration status: CHIP covers U.S. citizens and certain legal immigrants. States have the option of covering children and pregnant women who are lawfully residing in the United States. Undocumented immigrants aren’t eligible for CHIP.
http://www.healthcare.gov/using-insurance/low-cost-care/childrens-insurance-program/index.html


http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Childrens-Health-Insurance-Program-CHIP/Childrens-Health-Insurance-Program-CHIP.html

Also, what would prevent the other family members (spouse and children) from securing health care on the exchange?

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Response to ProSense (Reply #6)

Fri Feb 1, 2013, 11:08 AM

9. Thank you for posting that additional info. nt

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Response to McCamy Taylor (Original post)

Thu Jan 31, 2013, 09:24 PM

7. Conyers is reintroducing HR 676 for the 113th. He has 77 co=sponsors so far.

Get your Rep to join him!

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Response to annabanana (Reply #7)

Fri Feb 1, 2013, 11:06 AM

8. Good! he needs our support

 

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Response to McCamy Taylor (Original post)

Fri Feb 1, 2013, 11:29 AM

10. Bronze care for 4 member family to cost $20,000 by 2016

According to the IRS regs published yesterday.

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