Posted Thursday, June 20, 2013

The Patient Protection and Affordable Care Act, (PPACA), aims to increase affordability for health insurance for Americans. Government subsidies are one of the mechanisms that will be used in an effort to attain this goal.

All Americans must have health insurance beginning January 1, 2014 or face tax penalties, (see earlier blog, "Healthcare Reform Pros and Cons Part 4”). There are some exceptions to this rule. Exceptions will be allowed for: religious objectors, incarcerated individuals, hardship waivers, (individuals with income less than 100% of the Federal Poverty Level-FPL), members of Indian tribes, people with no income tax liability, individuals who are not lawfully present and individuals who are not covered for a period of less than three months during the year.

One of the strategies in California is to expand eligibility for Medi-Cal from its current level of 100% of the Federal Poverty Level, (FPL), to 133% of the FPL. Below is a table showing incomes for this expansion based on household size.

Household Size

Current Income Requirement for Medi-Cal

2014 Income Requirement for Medi-Cal

1

$11,490

$15,282

2

$15,510

$20,628

3

$19,530

$25,975

4

$23,550

$31,322

5

$27,570

$36,668

6

$31,590

$42,015

7

$35,610

$47,361

8

$39,630

$52,708

Subsidies will be available to qualified individuals with income levels of up to 400% of the Federal Poverty Level as of January 1, 2014. Keep in mind that the subsidy is a sliding-scale refundable tax credit paid directly to the health plan for individuals or families with incomes between 133% and 400% of the FPL; individuals must file a tax return in order to qualify. These subsidies are only available to purchase insurance inside the Covered California health insurance exchange. And remember, subsidies are NOT available to employees OR THEIR DEPENDENTS if an employer offers "affordable” coverage to the employee that meets the minimum value requirement of the government, (see earlier blog, "Is the Patient Protection and Affordable Care Act Really Affordable”). Refer to the chart below to see if you might qualify for assistance.

Household Size

150% FPL

200% FPL

300% FPL

400% FPL

1

$17,235

$22,980

$34,470

$45,960

2

$23,265

$31,020

$46,530

$62,040

3

$29,295

$39,060

$58,590

$78,120

4

$35,325

$47,100

$70,650

$94,200

5

$41,355

$55,140

$82,710

$110,280

6

$47,385

$63,180

$94,770

$126,360

7

$53,415

$71,220

$106,830

$142,440

8

$59,445

$79,260

$118,890

$158,520

Check back soon to learn more about the insurance benefits that will be offered within the Covered California Exchange. Healthy Solutions Insurance Services is available to assist both groups and individuals find and apply for affordable health insurance!


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