Ask the Times: Obamacare questions, asked and answered | Arkansas Blog

Tuesday, October 1, 2013

Ask the Times: Obamacare questions, asked and answered

Posted By on Tue, Oct 1, 2013 at 4:43 PM

Obamacare is here. Enrollment in the Arkansas Health Insurance Marketplace began today, with coverage set to start in January. But with the law gearing up, many still have questions about what the new coverage options mean for them. And we have answers! Here are a few queries we’ve received lately. Have a question about Obamacare and how it impacts you? Send to davidramsey@arktimes.com. Previous Obamacare Ask the Times here

Q:
 I’m trying to parse the Affordable Care Act for some young neighbors of mine. They are 30-35 years old. Two kids are both covered by ARKids. The husband is covered at his work — I don’t know details of his policy. They recently enrolled in the SNAP program. Income is in the $20,000 to $25,000 range. I think she should be eligible for Medicaid as well as the kids, but I am not sure. How does ACA help them and at what cost? These are nice, hard-working young people. They have been fed a lot of misinformation by someone.

A: For a family of four, if household income is less than $32,499 (138 percent of the federal poverty level), she qualifies for Medicaid via the “private option.” She can pick a private plan on the Arkansas Health Insurance Marketplace and will pay ZERO for a premium. Coverage will start Jan. 1. Probably the simplest way to sign up would be to show up at her county DHS office, the same place she likely went to for ARKids or SNAP.


Q: My work offers health insurance, but can I look for a plan on the Obamacare exchange instead?

A: If your employer offers you health insurance, you can choose to decline that and shop on the Arkansas Health Insurance Marketplace instead. However, if your employer offers coverage that is considered affordable and sufficient under the law, you are not eligible for Marketplace subsidies. Your employer will give you a letter that tells you whether the coverage offered meets minimum standards (your employee contribution cannot exceed 9.5 percent of your household income, and the plan must cover 60 percent of the total cost of medical services for a standard population).

An exception to the above: if your household income is less than 138 percent or less of the federal poverty level ($15,856 for an individual, $32,499 for a family of four), then you qualify for a zero-premium plan via the “private option” (see previous question) even if your employer offers you coverage.


Q: My spouse gets insurance through her job but I don’t. Am I eligible for subsidies?

A: If your spouse gets employer-sponsored insurance AND it meets the standards described above AND the employer offers spousal coverage, then you will not qualify for marketplace plan subsidies. The way this works in practice is a little funky: the rule that the employee contribution can’t exceed 9.5 percent of household income applies to coverage for the individual employee alone. If that’s below 9.5, the family will not qualify for subsidies, even if the employee contribution for spousal or family coverage is above 9.5 percent.

The same exception about the “private option” applies. If household income is less than 138 percent of the federal poverty level, you and you both qualify for a zero-premium plan via the “private option” even if your spouse’s employer offers your spouse coverage.

Tags: , , ,


Sign up for the Daily Update email
Favorite

Comments (8)

Showing 1-8 of 8

Add a comment

 
Subscribe to this thread:
Showing 1-8 of 8

Add a comment

More by David Ramsey

  • Authorities investigate accusation against Dean Elliott

    An accusation has been lodged against Dean Elliott, the Dillard's lobbyist and former state representative who is running for the District 15 seat in the state Senate, by a woman who claims that he was involved in a 2016 hit and run incident on Tennyson Drive in Conway that left her with severe injuries. Through a lawyer, Elliott says the allegation is false and politically motivated.
    • May 17, 2018
  • Rep. Jana Della Rosa disputes that Randell Shelton's Paradigm Consulting was a "bogus company"

    During the trial of former state Sen. Jon Woods and consultant Randell Shelton, the prosecution described Shelton's Paradigm Strategic Consulting as a "bogus company." But Rep. Jana Della Rosa, who paid Paradigm in 2014 for help with campaign messaging, said that Shelton did legitimate work for her.
    • May 16, 2018
  • A senator's vanity

    Spotted in Little Rock...
    • May 16, 2018
  • More »

Readers also liked…

  • Arkansas: Land of .......

    Welcome to Arkansas: Land of cowardly politicians, discriminatory laws, inhumane turkey drops and lots and lots of Trump voters.
    • Oct 8, 2016
  • Arkansas legislature rejects bipartisan effort to study race relations

    On Friday, the Arkansas Legislative Council soundly rejected a bipartisan effort by two senators to to create a temporary legislative subcommittee to study race relations in the state.
    • Sep 15, 2017
  • The inspiring Hillary Clinton

    Hillary Clinton's campaign for president illustrates again the double standard applied to women. Some writers get it. They even find the supposedly unlikable Clinton inspiring.
    • Oct 16, 2016

Most Recent Comments

Slideshows

 

© 2018 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation