Under the new law, an individual earning $14,000, which is currently 122 percent of the federal poverty level, would be eligible to receive:
Medicaid if he lives in a state that expands Medicaid to include coverage for individuals and families earning up to 138 percent of the federal poverty level. A provision of the Affordable Care Act funds the Medicaid expansion, at the states discretion.A significant federal subsidy to help pay for private insurance, if he doesnt live in a state that expands Medicaid. But he doesnt have to buy insurance, because he is also eligible for a hardship exemption that would exempt him from any tax penalties.Gohmert, a Texas Republican, made his comment on ABCs He was criticizing President Obama forbut not its individual mandate. Under the law, most Americans will be required to purchase health insurance or pay a penalty, beginning at .
Gohmert, Aug. 11: What about the poor guy out there making $14,000? Hes going to pay extra income tax if he cannot afford to pay the several thousand dollars for an Obamacare policy. Whos caring about him?Well, a lot of us do, but its not this president because he didnt let the individual mandate have a year off. He that only goes to big business. Thats not fair.Gohmert has repeatedly expressed concern about the guy making $14,000, as he did in aand in an interview on the ().
Gohmert, July 17: To force higher income tax rates on people making as little as $14,000 or so a year is grossly unfair by any standards, no matter how badly he wants to force Americans into ultimate government healthcare control.
Gohmert, Aug. 6: Were doing this for America, for the guy thats making $14,000 that would ultimately have an extra two and a half percent tax because Obama went after the little guy in Obamacare. Were doing it for those people.
But Gohmert is wrong, for several reasons. Lets start with the fact that the federal poverty level currently is , so $14,000 is 122 percent of the federal poverty level. A person earning that little would qualify for Medicaid next year in at least 23 states. Thats because the ACA expands Medicaid to include those earning up to 138 percent of the federal poverty level, which is $15,856 a year for 2013. The Medicaid expansion will not occur in every state, because the Supreme Courtsgave states the option not to expand it. As of July 1, 23 states and the District of Columbia support the expansion, while 21 are opposed and six are still considering it, .
So what happens to the poor guy out there making $14,000 in, lets say, Gohmerts home state of Texas ? He can buy a qualified health plan through anthat will be set up under the law, beginning Oct. 1. But it is not a requirement that he buys insurance. Thats because he will be eligible to receive a hardship exemption to the individual mandate and its tax penalty, under apublished July 1 by the Department of Health and Human Services. (See page 39525 under eligibility standards for exceptions.)
Federal Register, July 1: Ineligible for Medicaid based on a states decision not to expand. The Exchange must determine an applicant eligible for an exemption for a calendar year if he or she has been determined ineligible for Medicaid for one or more months during the benefit year solely as a result of a State not implementing section 2001(a) of the Affordable Care Act;
The Centers for Medicare and Medicaid Services announced the final rule in a . That release provided a list of reasons why a person would qualify for an exemption to the individual mandate including this one: Individuals who are ineligible for Medicaid solely based on a states decision not to implement the Medicaid expansion under the Affordable Care Act. This rule will protect individuals in states that, pursuant to the Supreme Court decision, choose not to expand Medicaid eligibility.
So, Gohmerts guy making $14,000 wont be penalized even if he lives in a state like Texas. But he would be eligible to receive a significant tax credit subsidy to help him buy insurance on the exchange, because the law also provides a sliding scale of subsidies to people with annual incomes between 100 percent and 400 percent of the federal poverty level, as the
Someone with a modified adjusted gross income of $14,000 would receive a significant tax credit to help pay for insurance. How significant? Awho has no children and earns $14,000 might expect to pay only $280 a year for insurance on the exchange. Thats because he would receive a tax credit subsidy of $2,883, covering 91 percent of the estimated $3,163 annual premium, according to the Kaiser Family Foundations
KFF estimates the subsidy would be even larger for aThat person who, again, has no children and earns $14,000 also would pay just $280 a year toward his insurance premium, even though the cost of his plan is estimated at $7,355.
(The calculator is for illustrative purposes only to give people an idea of how much they can expect to pay for insurance and receive in subsidies. Premiums on the exchanges are still being set. KFF assumes that the average premium for a single adult before subsidies would be $4,827, which is then adjusted based on a persons family size, age, tobacco usage and income.)
The new federal law allows insurance companies to charge higher premiums based on age and tobacco use up to a point. Older policyholders cant be charged more than three times the rate for younger policyholders and smokers 1.5 times more than nonsmokers. Its under this scenario that someone earning as little as $14,000 and living in a state that chooses not to expand Medicaid might have to pay several thousand dollars for an Obamacare policy, as Gohmert said. KFF estimates, for example, that awould have to pay nearly $4,000 even after receiving federal subsidies. But, as we said, that person isnt required to buy insurance and wont get hit with an extra income tax if he doesnt despite what the Texas congressman says.
Even low-income individuals who are not eligible for Medicaid because they earn above 138 percent of the federal poverty level currently $15,856 a year for 2013 are eligible for subsidies and possibly a hardship exemption. Thats because the eligibility standards for exemptions also state that a person must be granted an exemption if [t]he expense of purchasing a qualified health plan would have caused him or her to experience serious deprivation of food, shelter, clothing or other necessities.
Eugene Kiely
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