'Cause if you make too little to get a subsidy and too much to get Medicaid, you should be eligible for an exemption. Yeah, that doesn't get you health insurance, but at least you won't be paying a fine.

I put zero as of right now, as I'm not working (again). I put $10,000 for next year.

Description of the questions about income was so that they could determine subsidy/assistance.

None was offered.

Maybe you are in an medicaid didn't expand state? I am sorry, that sucks.

If you're in a state that didn't expand Medicaid and your income is between that state's cutoff for Medicaid and 100% FPL, you'll get an exemption (no fine) but no insurance. You're eligible to buy something on the exchange, but you won't be able to afford it.

it seems most that did not also have the congress critters of the party of NO. It boggles the mind.

should qualify for Medicaid. The problem being that some states where the (R)s refused to expand the program.


http://www.medicaid.gov/AffordableCareAct/Provisions/Eligibility.html


^snip^

The Affordable Care Act fills in current gaps in coverage for the poorest Americans by creating a minimum Medicaid income eligibility level across the country. Beginning in January 2014, individuals under 65 years of age with income below 133 percent of the federal poverty level (FPL) will be eligible for Medicaid. For the first time, low-income adults without children will be guaranteed coverage through Medicaid in every state without need for a waiver, and parents of children will be eligible at a uniform income level across all states. Medicaid and Children's Health Insurance Program (CHIP) eligibility and enrollment will be much simpler and will be coordinated with the newly created Affordable Insurance Exchanges.





I think the number is around $17,000 / yr.

If your income is more than 100% of the federal poverty level -- about $11,500 a year as a single person or about $23,500 for a family of 4 -- you will be able to buy a private health insurance plan in the Marketplace and may get lower costs based on your household size and income.
If you make less than about $11,500 a year as a single person or about $23,500 for a family of 4, you may not qualify for lower costs for private insurance based on your income. However, you may be eligible for Medicaid, even without the expansion, based on your state’s existing rules.

as of past Tuesday...I say it that way because supposedly there are on-going negotiations.

I am going to be really pissed if the Obama administration caves on that. What they want is:

- All the Federal money that would come through Medicare expansion; but the ability

1) to privatize this to their buddies in for-profit companies; and
2) still keeping all the bullshit rules such as really severe assets tests

If Obama caves on that, it is worst of all possible solutions because the hole will still exists and we will only be adding to the Republican privatizing graft machine, which is funding all the operations that have given us the Gerrymandering that enables the teabaggers in the first place.

He must not give in on this.

of the differences.

I don't get how a 27 year old in Wyoming has a more expensive silver offering than a 27 year old in New York City.

While I understand in Wyoming helicopter ambulances could be used proportionately more, it's my expectation that hospital staff and MD's/clinicians proper get paid a lot more in New York City.

Wyoming has fewer potential customers so insurance companies may not want to compete there.

Roughly $16,000.

The Kaiser calculator indicates that your premiums should be subsidized down to 3% of AGI or so or $549 per year.

http://kff.org/interactive/subsidy-calculator/

You can estimate at the 140%, which might trick the Exchange into not saying you should be in Medicaid -- in a state that isn't going to cover you on Medicaid. But if you make an application using that number, you are probably committing perjury because you have to attest that you are supplying accurate information.

...not generated. If you actually make $10000, just paying the extra tax on $6000 or non-existent income would be cheaper than paying for health insurance with no subsidy. Your return then serves as your proof of income.

I'd be tempted. As it stands, my family is caught in a different ACA donut hole, the "family glitch".

And still that really isn't a solution, is it? Paying tax on an extra $6000 income that you never received? The Federal tax might be relatively small, but you would also be subject to state income tax. I think we're probably talking another $1000 lost to taxes, which would be something like 10% of your actual income -- and you would still have to pay SOMETHING each month for the insurance policy. Even if that is only $100 a month, that now takes your effective income down to under $8000 a year.

Unless a person has a lot of sheltered assets/income, that won't be an option at all. You can't live on that.

I know it's wrong, but so was the choice not to expand Medicaid.

Very little chance of being audited for claiming MORE income than the IRS can verify.

I'd be tempted.

and it is usually tied to Federal AGI.

I agree with your general premise that (ignoring the question whether this would be considered a punishable crime) you would gain much more in insurance subsidies than you would pay in Federal and State tax combined. But is a person has only $10K of real income in the first place, they can't afford to pay any bogus tax or a $300/month subsidized policy. If the policy netted out to, say, $50/month, then it might work, but geez, that is a really tight budget.

That's what Medicaid expansion was for. I know we agree on that, but it needs to be reinforced. Almost half the states are not doing the Medicaid expansion, so there will be many, many people in the same situation as the OPer who are really screwed.

I say, estimate optimistically.

Cross the april 15th 2015 bridge when you get there.

there could be serious penalties. I bet it is more than just saying "Oops, I mis-estimated. here's the difference. 'Kay?"

b) It probably wouldn't pass the giggle test for Skip to estimate based on expecting to win the lottery in 2014, but I doubt that someone in the fifth percentile of 2013 earnings estimating that they'll be in the seventh percentile for 2014 would raise much concern.

The rich got rich partly by knowing the tax code and arranging their lives to make it comply with the behaviors that the code promotes. If you can save $4000 by increasing your income $4000, that's a net improvement of $8000. I think that for most people, this is doable - especially if you know of anyone in a similar circumstance to work with.

But I suspect that this thread is one big piece of performance art. Skip hasn't replied to any of the responses offering tangible and realistic solutions for the problem described in the OP.

Worst-case scenario; a taxpaying worker takes the tax credit based on their estimate of 101% of FPL 2014 wages. At tax time, they find that their wages were actually only 99% of FPL. The tax credit *could* be withheld from their tax refund.

All this presupposes that government does nothing (such as reduce the 100% subsidy limitation) to rectify the problem imposed by the court when they made medicare expansion optional.

You can potentially get a lot of people into some serious trouble.

See http://www.washingtonpost.com/blogs/wonkblog/wp/2013/09/30/%3Fp%3D63297/

"What if I get insurance through Obamacare and then I get a job that pays more money?

Well, go out and have a celebratory drink! And then celebrate more by...filling out some paperwork! If your income changes, you’re supposed to go back online and report that shift. Any federal help you get purchasing health insurance coverage will likely be adjusted to reflect your new income. The other option here is not to report your new income, although the government will figure it out when you file taxes the next year – and then look to recoup the tax credits you were not supposed to receive."

There are too many people like me who are self-employed, freelancers or small business owners...I can't predict my 2014 income today except to say it'll probably be between $0-$100000. (and 2014 is less than 3 months away.) I couldn't be more accurate than that if you stuck a gun in my face.

They're not going to imprison someone for being overly optimistic about their earning potential anymore than they would for being pessimistic...they just make you pay the taxes or in the case of optimism, it just makes your refund larger. They'd have to imprison a lot of small business owners who are off way more than $6K one way or the other if they did.

There is no reckoning to come from this.

and you might have to pay it back. I don't know if the IRS has outlined any additional penalties for that yet, but they very well might do so.

That's so fucking wrong on so many levels I don't even have words to say other than attitudes like that are, from TOP to BOTTOM the reason this country is in the shape it is in today.

The RICH think it's okay to lie and cheat, and they get away with it. The POOR (SOME of them) see the RICH lie and cheat and get away with it, and think "FUCK IT!? Why should THEY get a pass? What's good for the goose is good for the gander, right?"

So in the end; everybody who can get away with it lies, everybody who can get away with it cheats, and the people who can afford the least SUFFER THE MOST.

It blows me right the fuck away that you'd make a statement like that after picking The President's Name AND The Country's Name as your moniker.

Irony?

The exchange website is asking the poster of the OP to estimate his 2014 income.

It isn't in anyone's interest for him to fixate on the estimate which represents the worst possible case scenario. The whole point of the ACA was to get people who are in Skip Intro's position insured. The only reason he's in this quandary is because his governor elected to not accept federal money to expand medicare to people up to 138% of fpl. The ACA envisioned that some low income people might prefer private insurance, so it offers the option for people between 100% and 138% of FPL to take a tax credit subsidy. Subsidy or Medicaid? It's probably cheaper for us taxpayers to give the subsidy than it would be if Skip were to move to my state in which he'd be eligible for Medicaid.

In 2015, when doing his 2014 taxes (between then and now a great many things can happen, especially fixing the problem that was caused by the supreme court making medicaid expansion optional to each governor) he's obliged to accurately account for his income and pay the taxes consistent with the law as it exists at that time.

I say, think positive and plan on finding work in 2014 that lifts him above FPL and enter that into the exchange calculator. Or he could remain uninsured and get his care from the ER... for which we all pay.

...and not, absolutely I would fucking do it. Especially in light of the federal government wanting to subsidize my health care, but my asshole governor turning it down in a cynical attempt to score political points and favor with the fucking Koch brothers.

Besides that, if I get paid to do household chores for my neighbor and pay him to do the same for me, that is legitimate reportable income. Have a problem with that? Take it up with the IRS.

Mirrored by those who can't afford to or whose character won't allow them to, who suffer because of it. Triangulated by those who can't afford to cheat or lie but do it anyway because they see others get away with it, and get caught... their lives, and the lives of their families get fucked for generations.

Survival of the cheatest. That's what it's come to.

And fuck people, from the richest to the poorest, who think it's okay to cheat or subvert the system.

Just to get coverage. I suppose that would be scamming the system as well.

should MOVE.

AS.

IF.

Say I can't afford to pay the ACA premium... but you expect I can afford to FUCKING MOVE FROM ONE STATE TO ANOTHER? What the fuck is wrong with you? Is it THAT important to you to ACA that you'd suggest someone up and give up whatever meager employment they might have at the moment, leave whatever family they might be living near, and change their lives COMPLETELY, without any guarantee whatsoever they might have any kind of employment in the state they move to?

I've heard it all now.

I have spent days on this question, here on DU and with my state's people. I have a small business and my income per year varies by large numbers.

What I have been told is to do my best to estimate my income. If I underestimate it, then one returns the premiums not required. Overestimate, no one sees any problem with this. And I have repeatedly asked!

So, I agree with the other posters, that he should estimate his income to be enough to get a subsidy, and then when he does his taxes in 2024, he will be able to correct things.

Are creating havoc here. The IRS always wants us to be optimistic, in fact we get fined by underestimating income and witholding not enough.

Should make it easier for the admins to decide what to do with you.

I don't think it's unreasonable to plan based on the assumption that he's going to find a job in 2014.

When filing 2014 taxes, you'll have to use actual information, but I think there's good reason to doubt that those who are caught in that "donut hole" will actually be required to pay back the tax credit.

Personally, I think having access to health care is a high priority thing.

Say you and a neighbor in the same boat pay each other equal amounts to mow each other's lawn. That is legitimate reportable income.

I agree with you regarding access to health care. My family went 1.5 months last year without and it was agonizing to know how close we could be to financial ruin at any moment.

The only way to guarantee that nobody has to lie about their income is Medicare for all. Then it doesn't matter.

Obama and company have cobbled together a HORROR of a health care plan. "Affordable" Care Act, my fucking ass. They are all but guaranteeing that we will NEVER have single payer because of this nightmare. People will run away from that so fast, it'll make your head spin.

This is a disaster.

But, gee, get all sanctimonious because someone has to shade the truth in order to get marginally "affordable" health insurance. Meanwhile, fucking insurance companies are going to make a fortune.

I have a relative that pays over $300.00+ a month for Medicare parts A & B, plus another $800.00 a month for Kaiser as their supplemental plan; total is over $1100.00 a month last time I heard.

If you think I am making this up, look here:

If your yearly income in 2011 was You pay (in 2013):

above $214,000: $335.70

https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html

Said relative happens to be quite well-off needless to say.

Too bad this person doesn't like to "share" a little bit, that is about all I can say given the circumstances!

and accusing people in a rather nasty way. Clearly you have no experience with the IRS rules and the fines involved with under reporting income or you would be quiet. Knowledgeable people have posted about this, so please refrain from making statements that can cause people to be fined by the IRS. There is no problem believing that one will make more money that they end up making, the problem is stating that it will be lower than it ends up being.

and I have a few friends who will be doing this as well.

there's no way I would extrapolate that if this year I earned $100 that next year I would multiply my earnings by 10,000% the following year to $10,000. Why not estimate income on the low side based on this year's income and get the subsidy? if your estimate pans out, you can always adjust at some point. I am sure there is methodology for doing so.

your income was too low.

You were supposed to be covered by Medicaid (which I guess your state didn't expand), but you have to make more than 100% of the FPL to qualify for a subsidy (11,400 for a single male).

"Lowest Bronze plan for me was right at $300 per month, with a deductible of over $6,000 before anything kicks in, even a basic office visit. Can't afford that premium, much less the deductible."

...not how the deductibles work. A basic office visit, preventive care is free.

The ceiling for Medicaid varies from state to state, and is under 50% FPL in some places.

The OP is talking about on the federal exchange.

Still, I can't see how $10,000 wouldn't qualify for Medicaid.

And yes, there are states where 10,000 doesn't qualify for Medicaid.

on edit: a graph showing what the Medicaid and CHIP eligibility limits will be as of 1-1-14. http://medicaid.gov/AffordableCareAct/Medicaid-Moving-Forward-2014/Downloads/Medicaid-and-CHIP-Eligibility-Levels-Table.pdf

This is the result of actions by asshole Governors.

Basically, people in those states, until they come around, are subject to state laws.

This similar to Arizona holding out after Medicaid was first implemented.

because of a Supreme Court decision, but this difficulty should have been anticipated and provided for. Hopefully, they'll find a way to fix it without making half of the county wait for decades. Curiously enough, Arizona isn't on the "not participating in expanded Medicaid" list, so maybe they learned something from the last time around.

it was passed by Congress, signed by the President, and this is the part that was deemed consistent with the Constitution.

It's the law of the land. Yada-yada.

As a mantra indicating righteous infallibility and infallible righteousness, it's of equal validity here as in defending the ACA as a whole.

resulting in the 'expand or lose it all' Medicaid expansion part being found unconstitutional.

A family of two can only make around $250 a month in order to qualify.

Yeah, we didn't expand Medicaid. The governor wanted to but the teabaggers in Jeff City threw a fit-the same idiots who had a bust of Rush placed in the state Capitol building.

only the blind and/or totally disabled.

You can get it if you're pregnant. But that's it-nothing else.

And employers are cutting hours and benefits like crazy right now.

You do realize there are many states that have "opted out" of expanding Medicaid due to the SCOTUS ruling that said they could do just that?

For many of us, that means we are screwed. We gotta pay full price because they did not write into a contingency plan for something like that into the ACA when they wrote the law. Until that is fixed, those of us who would have qualified are just fucked. No affordable health care for us.

Three plans, lowest premium of Bronze, Silver and Gold.

Primary care doctor, no charge after deductible, lower left part of lower image.

It does provide much information.

The lowest deductible is $1,000 and the maximum out of pocket is $6,350.

It was a long page, that is the part containing the info you questioned.

I'll update this reply with the top image, that should make it more clear.

Your state isn't expanding Medicaid. So if you're on Medicaid now, why would that change? Or are you currently paying for health coverage?

You put in zero income for this year, and $10,000 for next year and got those rates?

zero for this year and 10K for next.

The fact that your state isn't expanding Medicaid is the problem. It's your Governor's fault, not the law's.

My current income is at zero right now because I am out of work. I've earned something like $5,000 this year. No, that doesn't qualify me for medicaid, last time I checked, which was earlier this year.

It offers no Medicaid to people with no income prior to the law, and then refused to expand Medicaid to comply with the health care law.

Screwed up state.

the law would do for me despite the states like mine who didn't expand medicaid.

You would pay nothing.

There are going to be a lot of people in the same situation.

Again, this is on your state for deciding not to participate.

The other problem is that the state's existing Medicaid structure sucks. It doesn't provide Medicaid for single individuals with no or low income.