Community Chat

[Goldengate8361]

And, this is bad because........?

Do you really know how little $11,000 is?

[SilleeMee]

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@Drythe wrote:

@SilleeMee 

So many rules are based on decisions made by your representatives in the state in which you reside.

Example:  I live in a state in which the State Legislature has voted AGAINST expanding ACA coverage, which would make it more affordable and include more people.

Perhaps you might be helped by visiting a certified Insurance Specialist.

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@Drythe 

Several years ago when this ACA stuff all started, it was required to find and use an insurance broker to obtain plans through the marketplace. So I have a broker and he does as little as possible. To say the least, I know more than he does about what's being offered in the marketplace! He's like an appointed public defender...just doing what the system tells him to do and nothing extra. It's such a joke.

[Carmie]

The CHIP program for children works this way too.  You must make a minimum of money to be accepted.  If you are under that amount, your application is sent straight to Medicaid.

That's how these federal health insurance policies work.  This is nothing new.

[NYC Susan]

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@Carmie wrote:

The CHIP program for children works this way too.  You must make a minimum of money to be accepted.  If you are under that amount, your application is sent straight to Medicaid.

That's how these federal health insurance policies work.  This is nothing new.

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Exactly.

Having a minimum makes sense.  And is actually helpful.  

[NYC Susan]

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@Mindy D wrote:

If you make under a certain amount you are not allowed to buy any ACA plan even if you want to pay for 

the plan yourself. You must earn or have income of at least  $12,140.  Suppose you have savings and want to use that money? Sorry, no.

‘Minimum Income

In addition to the maximum income to receive the premium subsidy, there’s also a minimum income to get accepted by the ACA marketplace. If your estimated income is too low, the ACA marketplace won’t accept you. They send you to Medicaid instead. In 32 states plus Washington, DC that expanded Medicaid, the minimum income is 138% FPL. In states that didn’t expand Medicaid, the minimum income is 100% FPL. Here’s a map showing which states expanded Medicaid and which stated did not: Current Status of State Medicaid Expansion Decisions, Kaiser Family Foundation.”

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@Mindy D wrote:

If you make under a certain amount you are not allowed to buy any ACA plan even if you want to pay for 

the plan yourself. You must earn or have income of at least  $12,140.  Suppose you have savings and want to use that money? Sorry, no.

‘Minimum Income

In addition to the maximum income to receive the premium subsidy, there’s also a minimum income to get accepted by the ACA marketplace. If your estimated income is too low, the ACA marketplace won’t accept you. They send you to Medicaid instead. In 32 states plus Washington, DC that expanded Medicaid, the minimum income is 138% FPL. In states that didn’t expand Medicaid, the minimum income is 100% FPL. Here’s a map showing which states expanded Medicaid and which stated did not: Current Status of State Medicaid Expansion Decisions, Kaiser Family Foundation.”

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How do you think someone with that income could pay for health insurance?  Sure, they might have savings, but I'm sure it's preferable to have free health insurance so whatever money they have can be used for other things - like food, clothing, utilities, etc.  And money in savings would be depleted pretty quickly if it had to be used for health insurance.  

Not having to worry about paying for health insurance is a good thing.  One less bill - especially for something so important - eases a huge burden.  This policy makes perfect sense.

[SilleeMee]

So if you qualify to purchase ACA insurance, that comes with such high deductibles so when you go to a doctor you still have to pay out of pocket and that's where the ACA falls short. Low-income people don't have enough money to pay the deductible. They might as well go without insurance...same thing.

[pigletsmom]

I think in most places you can go around the marketplace and just buy from the insurer but there wouldn't be any subsidy. It would make no sense otherwise. What if some 50 year old person that had made a couple of million dollars took a year off just because? I best not be payng for them to go on Medicaid because they have no income. Although I suppose they could if they wanted to but Medicaid stinks so that's unlikely to happen. I do remember stories about that in California I think when it first started. If you went on the site and filled out the stuff and say your only income was interest income so it was low, your stuff was sent right to Medicaid and it was an auto signup.

[SilleeMee]

All kinds of people cheat their income to get on Medicaid. That upsets me so much because I know some of those people and they appear to be living beyond their means and enjoying every minute of it, partying and gambling, on taxpayer money...on foodstamps, too. Some honest people who really need Medicaid can't get it.

[Anonymous032819]

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@Goldengate8361 wrote:

And, this is bad because........?

Do you really know how little $11,000 is?

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That's LESS than $1,000 PER MONTH.

I'd like to see anybody here try to live off of less than $1,000 per month.

[NYC Susan]

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@pigletsmom wrote:

I think in most places you can go around the marketplace and just buy from the insurer but there wouldn't be any subsidy. It would make no sense otherwise. What if some 50 year old person that had made a couple of million dollars took a year off just because? I best not be payng for them to go on Medicaid because they have no income. Although I suppose they could if they wanted to but Medicaid stinks so that's unlikely to happen. I do remember stories about that in California I think when it first started. If you went on the site and filled out the stuff and say your only income was interest income so it was low, your stuff was sent right to Medicaid and it was an auto signup.

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It's not that simple.  They look at assets too.  Someone who had millions of dollars (or any amount above the allowed limit in their state) would have to spend that money down before qualifying for Medicaid.  Marital status and other factors are also taken into consideration.  It's not just based on income from one year.

When the ACA was new, I had two patients who tried to sign up and were told they qualified for Medicaid and would be automatically signed up. However, when they continued the process, they were both denied because they had assets over the allowable limit.  The ACA just sends the info to Medicaid, and then Medicaid determines if the person actually qualifies.