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DeWayne Grice: No health insurance? ACA can help

DeWayne Grice: No health insurance? ACA can help

DeWayne Grice: No health insurance? ACA can help


Despite what you continue to see in the national news, the Affordable Care Act has brought about many positive changes to our health care system – especially for small business owners.

Three of the most popular changes are allowing children to stay on their parents plan to age 26, no more rating of policies for pre-existing conditions and tax credits applied in advance to offset premium cost. However, in order to prevent only sick people from signing up for health care, for the first time ever there is a national open enrollment for individual health care policies.

Individual open enrollment ends on Monday, March 31.  No matter whether you purchase your health care through the marketplace exchange or outside the exchange directly through an insurance company like, Humana or Blue Cross, your last opportunity to purchase individual coverage is Monday.

The only exceptions to this will be qualifying life events. That list includes: getting married or divorced, birth of a child, adopt a child or place a child for adoption, have a change of income, get health coverage through a job or a program like Medicare or Medicaid, change your place of residence, have a change in disability status, gain or lose a dependent, become pregnant, experience other changes that may affect your income or household size.

A CBS news poll released last week explained that the most common reason people are not signing up for insurance is that they can’t afford it. 

About 70 percent of the people planning not to purchase insurance are not aware of tax credits offered through the exchange that reduce monthly premiums and total out of pocket cost. In most cases, the reductions are dramatic. The income ranges that qualify for a tax credit are probably higher than most folks think. A family of four with an income up to $94,200 can qualify, as does an individual with income up to $45,960. 

Here are two examples of Bulloch County citizens who qualify for tax credit:

The most popular health care plan offered for Bulloch County on or off the exchange is a Human National POS Open Access plan. If a 27-year-old living in Bulloch County works a full time job at $9 per hour and has no dependents, they can qualify for full tax credit. His or her monthly cost for the Human Silver plan would be $0. In addition, at that income level, he or she qualifies for cost sharing, which reduces the deductible to $750 and a total out of pocket expense to $1,350 per year. Plus the individual would get free preventive care, which includes an annual physical.

A Bulloch county family of four with a total household income for 2014 of $85,000 would qualify for $389 per month of tax credit. If the family purchases the Platinum level Humana plan their monthly premium would be $599 per month, which has a $1,000 individual deductible and a $3,000 total family out-of-pocket maximum for the year. Free preventive care for each family member is part of the plan, as well.

Despite national efforts to promote the new health care law, many Americans are still unfamiliar with details of the program.

According to the CBS News poll, “Some 46 percent of those surveyed also were unaware of the March 31 deadline for being insured. Ignorance about the tax credits ran highest among Republicans and people in the West and South. More than 40 percent of people who identified themselves as Republicans said there are no tax credits to lessen the cost of insurance, compared with 20 percent of Democrats and 33 percent of independents. Slightly more than a third of those in both the West and South say the tax credits don't exist, compared with 25 percent in the Northeast and just 13 percent in the Midwest. Some 17 percent said they weren't getting insurance because they opposed the ACA, making that the second-most common reason cited for skipping coverage. Half of the Republicans who plan to stay uninsured said this was the main reason, compared with only 5 percent of Democrats.”

The most recent Census data indicates that nearly 20 percent of the population of Bulloch County is uninsured. If you are an individual that is self-employed or works at a job that does not provide health insurance, you should log onto Healthcare.gov or contact a local insurance agent to see if you qualify for tax credit through the marketplace. 

The tax credit is a use-or-lose credit. Despite many of the misstatements about the Affordable Care Act, it is not an entitlement program. You must have a job and income to qualify. The minimum amount an individual can make to qualify to purchase with a tax credit on the exchange is $11,670.

People who fall below $11,670 are not eligible for health insurance because Georgia chose not to expand Medicaid coverage.  Your only local option for affordable care in this situation is the Hearts and Hands Clinic on North College Street or East Georgia Healthcare in Metter, which is a federally subsidized clinic.

This is your last chance to enroll for this year. Explore your options and don’t miss out on what could be a life changing decision for you and your family. 

In 2013, bankruptcies resulting from unpaid medical bills affected nearly 2 million people. This makes health care the number one cause of bankruptcy filling in the U.S., outpacing credit card debt and mortgages.
DeWayne Grice is a business columnist for the Statesboro Herald, a local business owner and a licensed insurance agent.

 

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