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Your Money Adviser: Locked Out of the Insurance Marketplace

September 24, 2013 by

But if you are a low-income resident of one of 25 states, including Louisiana and South Carolina, you may miss out on financial help offered by the exchanges. That’s because those states haven’t expanded their offerings under Medicaid, the federal-state health program for low-income people, as the law envisioned. A list showing the expansion status of all 50 states and the District of Columbia is available on the Kaiser Family Foundation Web site.

A result is the frustrating situation in which you could qualify for financial help to buy coverage on the marketplaces — if only you made more money.

How did this happen? The health law aimed to cover as many people as possible in two main ways: creating marketplaces where people who don’t have insurance through an employer could buy affordable private policies; and expanding the number of people covered by Medicaid, which mostly has covered children and pregnant women.

In general, if you earn from one to four times the federal poverty level — about $11,500 to $46,000 for an individual — then you qualify for subsidies, given as tax credits, to lower the cost of policies bought on the exchanges.

Coverage for people earning below the poverty level was supposed to be handled by a federally funded expansion of Medicaid. But the Supreme Court ruled in June that expanding Medicaid was optional — and half the states chose not to do it, contending that the added costs would be too burdensome for taxpayers. The law didn’t anticipate the lack of Medicaid expansion, so there is a gap in coverage for those who don’t qualify for their state’s existing Medicaid plan, and who earn too little to qualify for financial help on the exchanges.

(It’s not clear precisely how many people are affected by the gap. But roughly seven million uninsured adults earn below the poverty level in the states that haven’t expanded Medicaid, according to the Kaiser Foundation.)

If you fall into the income gap, you can buy a policy on the exchanges — but you’ll pay the full premium. That’s “unrealistic” for someone making less than poverty income, said Ron Pollack, executive director of Families USA, which advocates for broader health care coverage. According to the Kaiser Foundation’s premium calculator, a 40-year-old man or woman who doesn’t smoke and earns $10,500 a year — below the poverty level — wouldn’t qualify for subsidies and would pay nearly $3,200 a year, or roughly a third of his or her income, for a “bronze” plan on the exchanges.

“The irony is that people with higher incomes can and will get help,” said Mr. Pollack.

One small consolation: If you would have qualified for Medicaid under the A.C.A. expansion, but your state isn’t participating, you’re exempt from the law’s requirement to buy coverage. So you won’t pay a penalty for not buying it.

Here are some questions to consider:

■ If my income is low and I’m uninsured, but I live in a state that didn’t expand Medicaid, should I apply for coverage on the marketplace anyway?

There’s no penalty for applying. And it may turn out that you qualify for coverage under your state’s existing Medicaid rules, but didn’t know it.

■ Could my state expand Medicaid coverage in the future?

Possibly. There’s no deadline for states to expand their programs, and some are still considering it.

■ Where can I seek medical treatment if I don’t have any insurance?

Check to see if there is a community health center near you; the cost of care at such clinics varies based on your income. You can search by ZIP code on the federal health care Web site: healthcare.gov/where-can-i-get-free-or-low-cost-care/

Article source: http://www.nytimes.com/2013/09/24/your-money/locked-out-of-the-insurance-marketplace.html?partner=rss&emc=rss

Filed Under: Your Money Tagged With: , ,

Economix Blog: Voices of the Near Poor

November 20, 2011 by Leave a Comment

When the Census Bureau this month released a new measure of poverty, meant to better count disposable income, it began altering the portrait of national need.

The new method, called the Supplemental Poverty Measure, was designed to add in many of the things the old measure ignored, like the hundreds of billions the needy receive in food stamps and tax credits. At the same time, it subtracted the similarly large sums lost to taxes, medical care and work expenses.

One surprising difference with the new measure, outlined in an article today, was the 51 million people with incomes less than 50 percent above the poverty line. That category, sometimes called “near poor,” was 76 percent higher than the official account, which was published in September. (The portion of people under the poverty line, meanwhile, increased by just 5 percent in the new measure.)

About a fifth of the people who appear near poor in the new measure are lifted out of poverty by benefits the old measure ignores, like food stamps and tax credits. But more than half were pulled down into near poverty from higher income levels by taxes, medical costs and work expenses like child care and gas. Taken together with people under the poverty line, a full third of Americans – or about 100 million people – live in poverty or in the economically vulnerable area just above it.

In Washington and its suburbs, the near poor are people with incomes between $31,693 and $47,539 for a family of four with a mortgage. Reporters talked to people in the Washington area this week with incomes in this category. They spoke of the knife-edge quality of their lives, in which one unexpected bill could knock them off balance. Many owned the usual trappings of middle-class life – cars, houses, cellphones and air-conditioners. But payments on those possessions were juggled, often unsuccessfully, depending on the unpredictable tides of their incomes. None saw themselves as poor. Most saw themselves as part of the middle class. But they focused on how hard they had to struggle to remain there.

Here are some of their stories:

Debra Jeje earned about $31,000 last year as a secretary in an emergency room in a hospital in Washington. She struggles to pay her bills, which come to about $2,300 a month, including groceries. She sells Mary Kay make-up for extra income. Gas, health insurance premiums and taxes put Ms. Jeje just above poverty line.

“What stresses me out most is payday,” said Ms. Jeje, who is 50 and has one son living with her. “I don’t have any extra money left over. My salary is less than my bills.”

Her job, she said, pays too little.

“We’re on the front lines,” she said. “There’s stress and headaches and ups and downs in the emergency room. You really feel that you’re worth more.”

Bille Allison, a health care worker with two children, earns $39,000 a year drawing blood at a doctor’s office in Maryland. She qualified for the earned income tax credit last year, bringing her income to $42,000. But work expenses dragged her down. She pays $500 a month for day care for her 4-year-old daughter, $100 a month for bus and train fare to get to work, and $200 a month for health insurance – bringing her income down to about $32,000. Some months she is able to save enough for game tokens and a meal at Chuck E. Cheese for her daughter. Other months she can only afford to pay half her bills. She was turned away from the food stamps office because her income was too high.

“I tried everything, and it’s like, nope, you make too much,” said Ms. Allison, who is 42 and divorced. “They tell you you have to work to get help, but then you work, and you still can’t get help.”

Jennifer Bangura works at Georgetown University Hospital as a cashier. Together with her husband, a driver for a catering company, their family income is just under $50,000, enough to pay a mortgage of $800 on a house she purchased in 1992. But after taxes, medical costs and the gas to get to work, they slip into the category of near poor. Their situation has been made worse by a second mortgage, taken out several years ago to raise money for their daughter’s college tuition. The monthly payment shot up to $2,200, an amount she says is now untenable.

“It’s killing me,” said Ms. Bangura, who is 50 and originally from Jamaica. She said she has been making payments for years and that “to lose it now would tear me apart.”

Jessie Adams, a floor refinisher and his wife, a secretary, together earn about $49,000 – too much to qualify for the earned income tax credit and food stamps, but too little to live without worrying about finances. Taxes and monthly subway commuting costs bring them down into the area of near poor. They own electronics – two flat-screen TVs and an Xbox game console for their 10-year-old – but cannot afford a car or a down payment on a house. Mr. Adams has not taken his family out on a weekend for five months.

“It shouldn’t be like this,” he said. “Two people working full time in the house, we should be able to save, to take a vacation. But it ain’t like that. It just ain’t like that.”

Article source: http://feeds.nytimes.com/click.phdo?i=669e4de749412712d8072c8b464da240

Filed Under: Economy News Tagged With: , ,

Economix Blog: More on Calculating Poverty

November 5, 2011 by Leave a Comment

Poverty researchers have been debating alternatives to the traditional poverty rate for years. So it’s not surprising that some people wondered why we chose the particular method that we used for today’s article about poverty.

Under guidelines established by National Academy of Sciences, the Census Bureau publishes eight alternative methods of calculating poverty. They are broadly similar. All take a fuller accounting of economic well-being than the official poverty measure does. They include benefits the official measure ignores, like food stamps and tax credits. And they subtract taxes, work expenses and out-of-pocket medical costs, which the official measure does not.

They differ in part by the way they account for inflation, with four using the Consumer Price Index and four using the Consumer Expenditure Survey.

One of the questions we wanted to ask was whether an alternative measure — by including many billions in increased safety-net spending — gave a different view from the official count of how much poverty has risen since prerecession days.

That question cannot be answered with the measures in the Consumer Expenditure Survey because of a change in its methodology in 2007, contaminating comparisons with earlier years. Therefore, under guidance from the Census Bureau, we chose the Consumer Price Index measure that most closely approximates a new alternative the bureau will release on Monday — the Supplemental Poverty Measure.

Our analysis of that measure showed the number of poor people had risen by 4.6 million people since 2006 — not by 9.7 million people as the official Census count reported in September.

Shawn Fremstad of the Center for Economic and Policy Research notes that the Supplemental Poverty Measure, being released on Monday, uses the Consumer Expenditure Survey and therefore differs from the method we used. That is true. But the Consumer Expenditure Survey measures cannot be used for prerecession comparisons. We used the next best thing — a measure that, like the measure coming Monday, includes a fuller account of income and expenses and adjusts for differences in costs of living.

It’s worth noting that since the methodological change occurred, both sets of alternative measures show poverty rising more modestly than the official measure does. From 2007 to 2010, poverty rose 2.6 percentage points by official count; 0.8 points on average by the four Consumer Expenditure Survey measures, and 0.9 points by the four Consumer Price Index measures. That bolsters our finding that alternative measures show poverty rising less than the official numbers suggest. It’s also worth noting that our findings echo those by researchers in Wisconsin and New York City, who also found safety net programs doing more than the official numbers show to restrain poverty growth.

By official count, there are 46.2 million Americans in poverty. Many experts think the Supplemental Poverty Measure may produce a slightly higher count, as our article noted. That is a different question from whether safety net programs have done more than the official count shows in restraining its growth.

Article source: http://feeds.nytimes.com/click.phdo?i=20933ebfca79c7e2d5d4769d3277a8ec

Filed Under: Economy News Tagged With: , ,