Monday, February 02, 2015

Too many aid-eligible ACA applicants say they were "told" otherwise

A Kaiser Family Foundation survey of 10,000 low- and moderate-income Americans conducted last fall finds, disturbingly, that half of those who say they were "told" that they did not qualify for government help obtaining coverage do appear to have in fact been eligible.

It's not entirely clear what respondents meant when they said they were "told" they did not qualify for aid. Many apparently sought outside help.  But it's all too easy to get a "false negative" from the exchanges themselves -- and ACA master navigator Kate Kozeniewski detailed for me several ways this could happen. My writeup is at healthinsurance.org;  a sampling of Kate's list is below. Note that the weak points extend in part to the phone hotline: in Kate's experience, you have to get a supervisor to deal with issues of any complexity.

  1. No tax return/no subsidy: At the very outset, Healthcare.gov asks whether the applicant plans to file a tax return – which many people who earn too little to owe income tax habitually do not do. If you click “no,” however it’s “no subsidy for you,” Kozeniewski notes ruefully. There is no warning about this – if you say that you’re not going to file a tax return, you simply move on through the application, and learn at the end that you are ineligible for help paying for coverage.
  2. Married? Then file jointly: If you’re married and file separately, you’re not eligible for subsidies. Here too, the website does not warn you that you’re forfeiting subsidies if you put down that you file singly. Kozeniewski has seen a surprising number of single filers. “It seems there’s a decent number of people estranged from their partners who have not gone through the steps of getting a legal divorce. We also see immigrants whose spouses are living in another country. There’s even a fair amount who are married and living in the same household, but who file separately for whatever reason.”
Read the rest here.

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