It's over in 8 days. We mean it this time!

The bureaucrats have changed their minds before. These are the last 8 days to buy health insurance for all those who 'didn't know' they would have to pay a penalty if they didn't have coverage. Smart, eh? Let the tax preparer tell you to go out and buy health insurance.

 

To answer the above question: Don't hold your breath.

The geniuses at Obamacare think they'll get more people covered by making it illegal to sell health insurance 305 days out of the year. 

Artificial scarcity. Usually, there are only 60 days in a year when people can buy individual/family health insurance. That is the 'open enrollment' period which runs from mid-October to mid-December. Unless political consequences get in the way and they move it (to avoid an issue with election fallout) or extend it (like they did the first year). Or re-open it as they did this year through April 30, 2015.

And there are about a dozen circumstances which allow for a 'special enrollment period' at other times of the year including my favorite: because we (the bureaucrats at the healthcare exchange) feel like it.

What happens if you don't buy health insurance?

For 2014, the penalty was $95 per person or 1% of yearly income per person (for the whole family) --whichever is larger.
In 2015, the fee increases to $395 per person or 2% of yearly income per person (for the whole family) --whichever is larger.
In 2016, the fee increases to $695 per person or 2.5% of yearly income per person (for the whole family) --whichever is larger.
The penalty is capped at the average yearly premium for a Bronze plan (the cheap plan), which is insurance that pays an average 60% of the cost of health care.
Children count half (each) and families are capped at 3x the above per-person numbers. So if it's a single parent with more than 4 kids... they're in luck!

So if you have a family with mom and dad and 3 kids... that's 2 x 2% (adults) + 3 x 1% (children) = 7%. That's 7% of their income. That's a huge chunk of money for a whole lot of nothing. Remember, that doesn't pay for coverage or anything else for them. It helps subsidize all those who get coverage for free or at greatly reduced cost.

Subsidies illegal in 37 states?

The Supreme Court will be hearing a case regarding subsidies in Obamacare. Turns out, the law says that state exchanges can offer federal subsidies. It does not say that the federal government can offer subsidies. Since 34 states use the federal government's portal (yes, the one that had so many problems last year), those states are at risk of losing subsidies for their citizens.

On the one hand it seems clear that the ACA was rushed due to undeniable political opposition, and this oversight is one of the consequences. On the other hand, it seems ridiculous that the court won't rule that the federal government has the authority to 'stand in the place of' the very states who are authorized to dole out the subsidies.

The reality is... ACA has changed the face of health insurance in this country. Good health is no longer a factor. Citizenship status is paramount. Costs are either ridiculously low (due to subsidies) or completely unaffordable. Meanwhile their are a lot of questions (like this one pending before the court).

FACT: If you spent the last 20 years as a drug user, then spent a stint in prison smoking several packs a day...you qualify for health insurance at the SAME RATES as those who have taken care of their health.

FACT: For moderate- and low-income families, if the cost of insurance seems too high they just need more dependents. That way the qualify for more subsidy.

FACT: ACA models are based on INCOME, not ASSETS. So if you are a multimillionaire with multiple homes and a muli-million dollar income, BUT you have solar tax credits that exceed your income... you know qualify for low- or no-cost insurance.

FACT: Immigrant children (born here as citizens) get free coverage through medicaid. Their parents, however, don't qualify for subsidies. So a paid policy for 2 people in their 20s costs $420/mo for bronze (with a $10,000 deductible: 2x $5000) or $490 a month for platinum. Both unaffordable.

What you may not realize is that insurance companies also have new procedures. So insurers who cover mostly healthy people now have to pay the government, which in turn gives the money to insurers who cover sicker people. It's a rather odd gave of chicken where insurers get multi-hundred-million-dollar checks to cover sicker (but not too sick in a costly way) people.

NY Times: what-ending-health-subsidies-means

Open or Not Open (health enrollment) / UPromise INFO

Can I get health insurance?

I'm still helping clients understand WHETHER OR NOT they can get health insurance, now that OPEN ENROLLMENT has closed. The health insurance companies are telling everyone 'no': Closed until November for 2015 enrollments.

But the truth is quite different. It turns out there are quite a few EXCEPTIONS. One of those exceptions is whether your income has changed. If you are Native American, you can change plans EVERY MONTH! So the rules are different depending on who you are, and whether you belong to a tribe.

That's because the geniuses at the federal government thought that the best way to get MORE people to buy MORE insurance was to RESTRICT WHEN it can be purchased. That's right; only 6 weeks out of the year. Unless you have one of several exceptions. Confused? You're not alone.

Businesses, of course, can buy health insurance any day of the year (it seems like only a few months ago that consumers could buy health insurance year-round too). The limitation is only on INDIVIDUALs. Businesses also get a delay on the mandate to buy insurance; individuals do not get a delay.

UPromise info [ <--Click here ]

Join the millions of families who have already earned $850,000,000 with Upromise®.

Now you can save faster just by doing the things you already do. With Upromise, every time you shop online, buy groceries or fill up your tank, you could be earning savings for the more important things in life. Best of all, it's free to join.

Open enrollment is...

Open enrollment is... 

still open in California. 

Just talk to a Certified Insurance Agent. Your agent can even help you find a plan that is off-exchange. But only for the next 13 days!!

The Government figures that the best way to get fewer uninsured is to make it IMPOSSIBLE to get health insurance 10½ months out of the year.

But Certified Enrollers--including Certified Insurance Agents--have until April 15th to get you enrolled.

April 15th is a good day. Nothing else is happening that day that is government related.
So, what genius at CoveredCA decided that that was the day to have another crush of sign-up activity?

Go figure.

If you qualify for subsidies, this is the last chance this year to cash in. If you don’t qualify for subsidies, you still have the same deadline even for policies that are not on the exchange. Genius alert: let's make it ILLEGAL to buy private health insurance EXCEPT during an open enrollment period. What a terrific idea?!?!

On Monday, May 31st (the ostensible deadline), there were hundreds of people lined up, taking off work, waiting for hours, to get their government health care taken care of. If only they would have known that have the whole first half of April to take care of it. Could at least some of them have managed to fit in the enrollment without disrupting their work schedule???

Speaking of geniuses in government...

The Administration says that 90% of people who “enrolled” in Obamacare have paid their premium. Really?

 

What kind of dream world do they live in?

It calls into question all the other unbelievable things they have been saying. Yet again.

Is this a joke?

If only...

Another day, another arbitrary extension of a key deadline. And this extension comes with the added attraction of adding ‘the honor system’ to those who seek coverage after the deadline.

John Boehner: is-latest-obamacare-adjustment-a-joke?

So everyone is knocking themselves out trying to meet the government-mandated, arbitrary deadline of March 31, 2014; and now you can apply later--but only if you really, really tried to get started before the deadline.

• What does that mean?
• How can it be verified?
• Which states will follow this new guideline?
• Does this only apply to the 37 states using healthcare.gov?
• Can other states adapt their software to even offer this?

I have been booked to help out a local clinic: all day Saturday, all day Monday. Monday was supposed to be the LAST DAY for sign-ups. Now, who knows?

It varies based on where you live

The states that run their own extensions make their own rules. For example, California says it’s residents have until midnight on April 15th. Oregon goes until April 30. NY isn’t budging from March 31. The Feds aren’t willing to give a date and time.

Here’s the whole story:
cbsnews.com/news/obamacare-deadline-fluid-depending-on-where-you-are

It seems like only last year...

Just last year, a person could sign up for health insurance WHENEVER THEY WANTED. Now you have to sign-up during a very brief ‘open enrollment period’. The whole rest of the year... nothing. Imagine: it is ILLEGAL to buy health insurance in May or June. UNLESS you qualify with a special exception (get married, get divorced, get a kid, lose job) . And UNLESS the government decides to ALLOW late sign-ups. In this case, on the honor system.

And the impact on insurance companies and state exchanges...

Can you imagine having to hire and train THOUSANDS of workers to help MILLIONS of confused people trying to get things squared away. Some of these people are facing life-threatening conditions and specialized treatment regimes that could jeopardize their lives and livelihood. Oh, by they way, we only need you for SIX WEEKS.

The whole rest of the year you can find something else to do.

Unless the president changes his mind.

Video: Hitler Finds Out He Can’t Keep His Doctor Under Obamacare

Hitler Finds Out He Can’t Keep His Doctor Under Obamacare

Now all he can afford is ObamaCare Bronze level, with a 40% copay after a $5000 deductible.

 

I like how the worker-bees are sent out of the bunker room, but they can still hear the ranting and raving.

I had an interesting experience on Saturday. I was helping people evaluate their choices before the looming 3/31 deadline. After paying hundreds of dollars per month, one got NO COVERAGE or help with medical costs until AFTER he pays a $5,000 deductible.

That person shook his head and said: it's not worth it. I'll just pay the penalty.

I have to wonder who designed the 'metal tier' programs (Bronze, Silver, Gold, Platinum). The tiers are so similar, there aren't any TRUE low-cost choices (unless you qualify for taxpayer assistance). Maximum out-of-pocket, unlimited amounts, pregnancy coverage for males and females, no discount for not smoking (in California and some other states), all of the policies are loaded up with things people don't want to pay extra for. But insurers are PROHIBITED from offering lower-cost policies that have what people do want.

And if your income is TOO LOW, you get no premium assistance. You are forced into Medicare, whether you want it or not. The same is true for middle-income families with kids. The kids are forced into Medicare so they don't have the same coverage or provider network as their parents, or even their older siblings. The rest of the family (adults) could pay $1 a month for coverage, but the kids HAVE TO either take Medicare or pay HIGH, UNSUBSIDIZED premiums. Some choice.

It isn't free if your neighbor is paying your share.

Obamacare giveth and Obamacare taketh away.

Dazed and Confused

Typical website experience for the healthcare exchange. Pick a plan, but no way to make a payment.
Not at CoveredCA’s website, the insurance company’s website. Nothing.

AND then have to upload or fax in documentation on income and residency within 90 days.

• How many people will forget to do it in 90 days. 
• How many will be confused by what is being asked for?
• Could this be any more complicated?

True Sample

Here is a sample of documents requested for a 16-year-old high school student, daughter in a family that has conditionally qualified for Advanced Premium Tax Credit. 

Note how they ask for a “Copy of last year's federal tax return that accurately reflects current income” 4 TIMES!!! If she’s a full-time student and DOESN’T HAVE ANY OF THE THINGS on the list, what does she do? How do you upload a ‘no document’?

• Copy of last year's federal tax return along with federal schedule E that accurately reflects current income (1)

• Other documents to support Proof of Rental Income

• Receipts displaying gross profit and expenses

• Business records such as profit and loss statements

• Copy of last year's federal tax return along with federal schedule C. D, E, or F as appropriate that accurately reflects current income (2)

• Other documents to support Self Employment Income

• Court papers

• District Attorney/Family Support (DAFS ) records

• Copy of check

• Copy of pay stub

• Copy of pay stub showing garnishment specified for alimony

• Sworn affidavit from absent parent

• Other documents to support spousal income and child support

• Award letter or most recent cost-of-living increase notice

• Current bank statement

• Copy of the current benefit check

• Signed statement from the individual or organization providing the income

• Copy of last year's federal tax return that accurately reflects current income (3)

• Gift income letter

• Other documents to support Proof of Unearned Income

• Pay stub

• Copy of last year's federal tax return that accurately reflects the current income (4)

• Signed letter from employer that displays the gross income, payment frequency, and date of paycheck

• Affidavit

• Other documents to support Proof of Earned Income

• Form 1099

• Bank statement

• Investment account statement

• Payment records (notes and mortgages)

• Other documents to support Proof of Interest Income

• Lease or sales agreement

• Records such as gross rents and expense receipts
•  

Did I lose you somewhere in the above list?

Here’s another question:
What do you do if your federal tax return from last year doesn’t reflect current income?
The enrollment period is ALWAYS before the tax filing date. Which means in March 2014, people still haven’t filed their 2013 taxes. Which means they need their 2012 tax return. What if the 2012 tax return doesn't accurately reflect their 2014 income?

And for self-employed people and entrepreneurs: what if they won’t even know their 2014 income until they file in October of 2015? Oh, that’s right--you can’t wait that long to file taxes and get the Advanced Premium Tax Credit. Yet another way self-employed people are at a disadvantage with this law.

But I am using a 2012 tax return to gauge 2014 income which I won't know for sure until the middle or end of 2015. What if I’m wrong?

If you guess high, you'll get more of a tax refund--the government sat on your money for 16 to 22 months. If you guess low, you’ll owe more: about 9.5% of any additional income. That’s quite a tax ON TOP of self-employment tax of 15.3%. [That makes a combined self-employment/health insurance tax of about 24.8%!!!] And that’s before state and federal taxes.

But that was being optimistic. 

There are some very common scenarios where your kid earns $2000 by working a part-time job over the summer, and you (the parent) now owe ALL OF IT in additional taxes on your health care program. That’s in addition to payroll taxes (FICA, state and federal unemployment, etc) your kid pays.

Obamacare giveth and Obamacare taketh away.