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Those Left Out of Medicaid Expansion Won’t Be Penalized … Or Insured

Posted By Kaiser Health News On June 28, 2013 @ 3:01 pm In Washington Watch | Comments Disabled

By Alvin Tran, Kaiser Health News

Low-income Americans who live in states that have decided not to expand Medicaid eligibility will not face penalties if they fail to buy insurance next year.

Discussion: 78 million consumers saved $3.4 billion on ACA-provisioned health insurance [1]

medicaid-card [2]That’s according to a final rule on exemptions to the health law’s individual mandate – the law’s controversial requirement that most Americans have health coverage or pay a penalty [3] in 2014. That rule was published Wednesday.

The health law calls for an expansion of Medicaid [4], the federal-state insurance program for low-income Americans, by making it available to people up to 138 percent of the federal poverty level, which for individuals is $11,490 in 2013, and providing new federal funding to cover the costs for the first three years, and no less than 90 percent after that. But the Supreme Court ruled last year that states could not be forced to join in that program. About half the states so far have opted against the expansion, a concern for supporters of the law because it could leave millions of people without access to affordable coverage.

Related: Countdown to Care – Medaid’s Winners and Losers [5]

The law provides subsidies to help low-income people, but they are available only to those who earn between 100 and 400 percent of the poverty level. Individuals and families earning less than 100 percent who live in states not expanding Medicaid have few, if any, options for affordable insurance.

The final rule is similar to draft proposals from the U.S. Department of Health and Human Services [6] and Treasury [7] in January.

Those who do not have health coverage, and who do not meet the criteria for exemptions, must pay the penalty [8] at the end of the tax year.  The penalty for the first year [9]is $95 per adult and $47.50 per child, or 1 percent of family income, whichever is greater, and it increases over time.

 

Also of Interest

 

See the AARP home page [13] for deals, savings tips, trivia and more

 


Article printed from AARP: http://blog.aarp.org

URL to article: http://blog.aarp.org/2013/06/28/states-not-expanding-medicaid-wont-penalize-uninsured-low-income/

URLs in this post:

[1] 78 million consumers saved $3.4 billion on ACA-provisioned health insurance: http://www.aarp.org/online-community/groups/index.action?slGroupKey=Group1472&slPage=showDiscussionPost&slForumPostKey=Cat%3aprivateForum%3a5606be00-fd7c-454b-abb5-f7866b3f5f55%40D|9%3b9|CommGroupGroup1472|Discussion%3a0b0ac79a-8061-4456-9ecc-1b5604de9217@intcmp=AE-IL-CONT-COMM

[2] Image: http://blog.aarp.org/wp-content/uploads/2012/12/medicaid-card.jpg

[3] requirement that most Americans have health coverage or pay a penalty: http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision

[4] expansion of Medicaid: http://www.kff.org/medicaid/fact-sheet/key-considerations-in-evaluating-the-aca-medicaid-expansion-for-states-2/

[5] Countdown to Care – Medaid’s Winners and Losers: http://blog.aarp.org/2013/06/26/countdown-to-care-winners-and-losers/?intcmp=AE-BLIL-BL

[6] Department of Health and Human Services: http://www.gpo.gov/fdsys/pkg/FR-2013-02-01/pdf/2013-02139.pdf

[7] Treasury: http://www.gpo.gov/fdsys/pkg/FR-2013-02-01/pdf/2013-02141.pdf

[8] pay the penalty: http://blog.aarp.org/2013/05/30/medicaid-revolving-door-costs-beneficiaries-more-in-enrollment-fees/?intcmp=AE-BLIL-BL

[9] penalty for the first year : http://www.kff.org/infographic/the-requirement-to-buy-coverage-under-the-affordable-care-act/

[10] Medicaid Expansion Would Help Many Midlife Adults: http://blog.aarp.org/2013/04/29/medicaid-expansion-would-help-many-midlife-adults/?intcmp=AE-ENDART1-BL-REL

[11] 5 Reasons to Care About Medicaid Expansion: http://blog.aarp.org/2013/05/15/5-reasons-to-care-about-medicaid-expansion/?intcmp=AE-ENDART2-BL-BOS

[12] Join AARP: https://appsec.aarp.org/MSS/join/application?intcmp=AE-ENDART3-BL-MEM

[13] AARP home page: http://www.aarp.org/?intcmp=AE-ENDART3-BL-HP

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