Learning, Sharing, and Teaching > Ask a Mustachian
Information on the Affordable Care Act, with a focus on early retirees
forummm:
MOD NOTE: This thread is for general information/FAQs about the ACA. It is not for individual questions, which will just lengthen/clutter/confuse. If you have questions about your individual situation, please start a new thread. Cheers!
There are many posts from people asking questions about how to get healthcare in early retirement. The topics tend to center around the Affordable Care Act (ACA). The ACA is very complicated, but is an important policy for people--and early retirees in particular--to understand.
The intent for this thread is to provide (whether through linking or discussion) comprehensive information and answers to questions about the ACA. I know the ACA is a contentious topic. For the sake of promoting accurate and actionable information, let's please leave this thread only for information about what the ACA's policies are--and not whether they are a good or bad idea. There are plenty of other threads here that discuss the merits and demerits for the law at length.
Please post any questions you have about the law. This is a policy with so much complexity that it's hard to write out a complete guide. Your questions will help the thread develop into a more complete source of information. I will take responsibility to help answer the questions along with other interested and informed forum members.
Here are two resources developed by two of our fellow forum members that are good starting places for information:
https://seattlecyclone.com/optimizing-the-affordable-care-act/
http://rootofgood.com/affordable-care-act-subsidy/
And here are some threads of Q&As that may be of interest:
http://forum.mrmoneymustache.com/ask-a-mustachian/obamacare-blues-but-i-don't-want-medicaid/
http://forum.mrmoneymustache.com/ask-a-mustachian/aca-question/
http://forum.mrmoneymustache.com/ask-a-mustachian/aca-subsities-and-medicare/
madamwitty:
Great topic!
I read through both seattlecyclone's and Root of Good's guides. I've seen repeated reference to ACA subsidies not being available below 138% of FPL in states with expanded Medicaid. But the state-by-state table linked from RoG's guide shows Medicaid only covering adults up to 133% of FPL in many states. (I am looking specifically at CA and WA, but others do this too.) Is there a gap?
Link to table: http://www.medicaid.gov/medicaid-chip-program-information/program-information/downloads/medicaid-and-chip-eligibility-levels-table.pdf
MidWestLove:
My question to people using ACA or exchange purchased plans - how is the pricing and subsidies work in cases where income is actually unknown until the end of the year? i.e. there is a certain base and on the top there are dividends and capital gains that I can not predict directly, how does act of purchasing insurance work?
- it is based on previous year numbers (which may or may not be correct since you are no longer working)
- it is some sort of 'honor' system in which you state income and at the end of the year there is some validation
- something else
Thank you
seattlecyclone:
--- Quote from: madamwitty on June 29, 2015, 04:57:08 PM ---Great topic!
I read through both seattlecyclone's and Root of Good's guides. I've seen repeated reference to ACA subsidies not being available below 138% of FPL in states with expanded Medicaid. But the state-by-state table linked from RoG's guide shows Medicaid only covering adults up to 133% of FPL in many states. (I am looking specifically at CA and WA, but others do this too.) Is there a gap?
Link to table: http://www.medicaid.gov/medicaid-chip-program-information/program-information/downloads/medicaid-and-chip-eligibility-levels-table.pdf
--- End quote ---
This page seems to explain the discrepancy. Apparently the official minimum income cutoff for Medicaid (in states that opted into Medicaid expansion) is 133%, but due to technical reasons they subtract 5% from your real income when calculating your income for the purposes of determining Medicaid eligibility, so the effective cutoff is 138%.
forummm:
--- Quote from: seattlecyclone on June 29, 2015, 06:19:46 PM ---
--- Quote from: madamwitty on June 29, 2015, 04:57:08 PM ---Great topic!
I read through both seattlecyclone's and Root of Good's guides. I've seen repeated reference to ACA subsidies not being available below 138% of FPL in states with expanded Medicaid. But the state-by-state table linked from RoG's guide shows Medicaid only covering adults up to 133% of FPL in many states. (I am looking specifically at CA and WA, but others do this too.) Is there a gap?
Link to table: http://www.medicaid.gov/medicaid-chip-program-information/program-information/downloads/medicaid-and-chip-eligibility-levels-table.pdf
--- End quote ---
This page seems to explain the discrepancy. Apparently the official minimum income cutoff for Medicaid (in states that opted into Medicaid expansion) is 133%, but due to technical reasons they subtract 5% from your real income when calculating your income for the purposes of determining Medicaid eligibility, so the effective cutoff is 138%.
--- End quote ---
The way it's phrased is that coverage is officially at 133% but there's a 5% "income disregard". You know, because 133% is just too simple :)
I should mention that the obamacarefacts.com website is not a reliable source of information. I've found incorrect statements there on several occasions.
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