Wednesday, March 25, 2020

America Will Dramatically Change the Way It Provides Health Care by 2030

A benefits specialist looks ahead and sees... something for all. Not Medicare.

Sunday, March 8, 2020

Californians Must Buy Health Insurance or Face a Penalty Unless ... They Don't Want To | 24 Flavors of Exemption

At one point in time, Obamacare was up to 32 exemptions to the individual mandate as politicians (particularly those in favor of government healthcare) realized it was really bad for reelection purposes to go around penalizing the people who were likely to keep them in office.  Finally, federal politicians capitulated and congress eliminated the individual mandate penalty (tax).

What about Obamacare's pay-fors, fiscally responsible citizens might ask.  Don't be so silly.  U.S. political leaders needn't concern themselves with such trivial nuances.  As originally passed, PPACA was slated to cost just under a trillion dollars over ten years.  Now, it will cost just under two trillion.  But really, who cares about a trillion here or there when we are already $23.5 trillion in debt and neither party ever seriously makes any move to address the problem.

California is now following the same path as we in the Golden State have super-charged our version of PPACA.  In California folks can qualify for other people's money to help them buy health insurance so long as they make less than 600% of the federal poverty level (FPL).  That is right, 600 percent or a paltry $154,500 for a family of four.  That is not a typo.  Calunicorinians saw Obamacare's 400% and increased it by 50%.  Because, you know, we are Calitopia! 

In any event, I just stumbled across a fun list.  You see, California's politicians just like Obamacare's original supporters, really want no part of forcing their constituents into buying a health plan that they don't want.

Therefore, in California, you must buy health insurance for you and your family (with other people's money if you make under 600% of the FPL) unless:
  1. Your income below the state tax filing threshold.
  2. You had a coverage gap of 3 consecutive months or less.
  3. Your health coverage is unaffordable, based on actual income reported on your state income tax return when filing taxes.  This means that the cost of the lowest cost Bronze plan through Covered California or the lowest cost employer-sponsored employee-only plan is more than 8.24 percent of income on the tax return.
  4. Certain non-citizens who are not lawfully present.
  5. Citizens living abroad or residents of another state.
  6. Members of a healthcare sharing ministry
  7. A member of a recognized religious sect or division who is opposed to acceptance of the benefits of any private or public insurance.
  8. A member of a religious sect or division who relies solely on a religious method of healing.
  9. American Indians. 
  10. Alaska Natives.
  11. Incarceration.
  12. Enrolled in limited or restricted-scope Medi-Cal or other similar coverage.
  13. Experienced homelessness.
  14. You were evicted in the past six months or are facing eviction or foreclosure.
  15. You received a utility shut off notice in the last year. 
  16. You have experienced domestic violence.
  17. Death of a close family member.
  18. Natural disaster (i.e. fire, flood, or human-caused disaster).
  19. Bankruptcy.
  20. Medical expenses that resulted in substantial debt.
  21. Unexpected increases in necessary expenses or decreases in household income due to divorce/separation, unexpected or sudden disability, or caring for an ill, disabled or aging family member.
  22. Appeals decision shows eligibility for enrollment through Covered California when not actually enrolled.
  23. Medical support order.
  24. Other (granted on a case-by-case basis). The state form for the general hardship application is only 11 pages.  
So how many Californians will actually pay one of these fines?  A quick perusal of the list shows than you can skip paying a utility until the last possible moment to generate a shut off notice for yourself.  Bang!  A get out of Obamacare free card.  

This is nothing more than charade to make it look as if we have an individual mandate without really having one.  And the only folks who will actually end up paying this tax/penalty are those who are totally caught off guard or just not even trying a little bit.   

What will the fine be for those who actually do have to pay?  

The penalty will be the higher of either:
  • A flat amount, based on the number of people in the tax household ($695 per adult and $347.50 per child), or
  • Pay 2.5% of the amount of gross income that exceeds the filing threshold requirements based on the tax filing status and number of dependents.  
The state has been kind enough to provide you an example of this here.