The Kaiser Family Foundation has this report on health insurance premium tax credits (subsidies) available through the new insurance marketplace.

The report explains how the subsidies work and who is eligible. It also has estimates of the number of eligible people by state. Nationwide, they estimate that 17 million uninsured are eligible.

In Tennessee, they estimate that 387,000 people are eligible for premium tax credits, and that as many as 645,000 could shop for insurance through the marketplace.

Their methodology states: "As with our estimates for tax-credit eligibles, the estimate for the number of people who might look for coverage in Marketplaces starts with people legally residing in the United States who are uninsured or have nongroup coverage and have incomes above Medicaid and CHIP eligibility levels."

I'm wondering if that includes people who have income that would qualify them for Medicaid under federal guidelines but can't get it because it is not offered in their state, like in Tennessee.

State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the Affordable Care Act

Moon's picture

determining the denominator

R. Neal wrote
I'm wondering if that includes people who have income that would qualify them for Medicaid under federal guidelines but can't get it because it is not offered in their state, like in Tennessee.

We've reviewed most of these reports and I seem to recall that the Kaiser study does include anyone up to 140 percent of "poverty level," regardless of their state's decision on participating in optional Medicaid expansion.

R. Neal's picture

And even in Tennessee, people

And even in Tennessee, people at 100% of poverty are only eligible if they belong to certain "classes," such as having dependent children. I believe there are five. Working poor is not one of them.

Up Goose Creek's picture

?

I find it ironic that the KFF knows whether I will be eligible for a subsidy when even I don't know what my income will be next year.

Maybe this is an admission that the middle class really HAS disappeared.

On a serious note, does anyone know how healthcare.gov deals with people with irregular incomes? Becky?.... Bubba?.... Bueller...?

R. Neal's picture

Good question. Here's what

Good question. Here's what appears to be the definitive answer:

Subject: Frequently Asked Questions on Health Insurance Marketplaces and Income Verification

Also, I'm pretty sure that you are supposed to update your situation if/when it changes to remain eligible.

B Harmon's picture

yes

If you win the lottery you can change your status and let go of the subsidy.

That also applies to loosing a job or other situation where there would be an increase in the subsidy.

B Harmon's picture

it is up to you

KFF is working on what you enter as your projected 2014 income. If you are eligible for a subsidy, when you enroll in a plan, you have the opportunity to decide how to take that "premium tax credit". You can apply it to the monthly premium to lower that cost, you can apply some of it to your monthly amount but not all*, or you can wait and take it all at the time you file your 2014 taxes as a big lump sum payment.

If you make more than you stated in your income projection and took the monthly reduction, then you would have to pay back some of the credit. So it would be wise to err on the side of caution if your income is irregular, wait till the end of the year and get some back

* I may be wrong on the specifics on this,but I do know there are several options of how you can apply the tax credit.

fischbobber's picture

Subsidies

I was under the impression that the next wave of challenges to the ACA would come from a glitch in the legislation the excluded citizens from the states that chose not to expand medicaid from receiving the subsidies. Was I a victim of still more misinformation?

Up Goose Creek's picture

Most needy

I've heard that too, Bob, and it seems like a cruel hoax. And what if someone loses their low paying job 2/3 way through the year and becomes too poor to be eligible for subsidies? Is the IRS going to come back at them? Talk about adding insult to injury. Blood, turnips, etc.

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