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Help me understand the ACA

Baralis

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With all the recent talk of the ACA I decided to look into how it would affect my father. The information I have found has indicated that he will not only be in the same poor position that he is in currently but now he will also have to pay a $95 fee for 2014.

My disabled father which is on several medications (that he no longer takes because he cannot afford them) and had serious heart disease received medicaid for free in 2012 but in 2013 he started to receive his social security checks ($8900 annually, his only income). This made him ineligible for free medicaid. Now to receive medical assistance under medicaid he has to pay a monthly premium of $168 for any month that he wishes to be covered. While this seems like a bargain at only $168 a month a person trying to live on $8900 annually it is an impossible hurdle.

With the ACA it seems that his income puts him into the medicaid bracket since he cannot afford insurance and his income is so low. Missouri however is refusing to expand the medicaid program under the ACA so it would seem he is left with the same choice. Pay $168 a month or live without any type of medical coverage. To make matters worse it seems he will be required to pay a $95 annual fee in 2014 which more than triples in 2015 and continues to increase each year for not being insured. If the information that I have gathered is correct it would seem the ACA will in fact make his situation worse and not better. I thought it was about helping those that could not afford health care and not increasing their financial burden?

My question to the community: is my understanding correct or do I have something wrong?
 
With all the recent talk of the ACA I decided to look into how it would affect my father. The information I have found has indicated that he will not only be in the same poor position that he is in currently but now he will also have to pay a $95 fee for 2014.

My disabled father which is on several medications (that he no longer takes because he cannot afford them) and had serious heart disease received medicaid for free in 2012 but in 2013 he started to receive his social security checks ($8900 annually, his only income). This made him ineligible for free medicaid. Now to receive medical assistance under medicaid he has to pay a monthly premium of $168 for any month that he wishes to be covered. While this seems like a bargain at only $168 a month a person trying to live on $8900 annually it is an impossible hurdle.

With the ACA it seems that his income puts him into the medicaid bracket since he cannot afford insurance and his income is so low. Missouri however is refusing to expand the medicaid program under the ACA so it would seem he is left with the same choice. Pay $168 a month or live without any type of medical coverage. To make matters worse it seems he will be required to pay a $95 annual fee in 2014 which more than triples in 2015 and continues to increase each year for not being insured. If the information that I have gathered is correct it would seem the ACA will in fact make his situation worse and not better. I thought it was about helping those that could not afford health care and not increasing their financial burden?

My question to the community: is my understanding correct or do I have something wrong?

i don't know if you will consider the information on this site because of its liberal lean, but it does try to provide answers to some questions about the affordable care act

20 Questions You Have About Obamacare But Are Too Afraid To Ask | ThinkProgress
 
If he is on social security, is he not eligible for Medicare? I would have thought he would be.
 
i don't know if you will consider the information on this site because of its liberal lean, but it does try to provide answers to some questions about the affordable care act

20 Questions You Have About Obamacare But Are Too Afraid To Ask | ThinkProgress


Very nice, thank you. It would seem from that link that an individual making less then $10,000 are exempt from the penalty by not being required to file his taxes. While not an improvement at least it isn't further impeding him.
 
Very nice, thank you. It would seem from that link that an individual making less then $10,000 are exempt from the penalty by not being required to file his taxes. While not an improvement at least it isn't further impeding him.

There are also individual assistance numbers you can call on the site where you sign up.
 
In Illinois, my Mother did not get enough Social Security to get Medicaid to move into assisted living. However, Dad's Civl Service check saved her, not to mention Tri-Care-For-Life. My question is whether ACA is being prevented for the elderly by Red states purposely throwing up roadblocks.
If he is on social security, is he not eligible for Medicare? I would have thought he would be.
 
If he is on social security, is he not eligible for Medicare? I would have thought he would be.

You would think so but it is not the case. The month he started to receive his SS they told him that under federal guidelines he was no longer eligible for free medicaid. He had to chose one or the other. They also cut his food stamps to $16 per month (from $200ish). I guess they think $8900 annually is enough for a person to take care of themselves.
 
With all the recent talk of the ACA I decided to look into how it would affect my father. The information I have found has indicated that he will not only be in the same poor position that he is in currently but now he will also have to pay a $95 fee for 2014.

My disabled father which is on several medications (that he no longer takes because he cannot afford them) and had serious heart disease received medicaid for free in 2012 but in 2013 he started to receive his social security checks ($8900 annually, his only income). This made him ineligible for free medicaid. Now to receive medical assistance under medicaid he has to pay a monthly premium of $168 for any month that he wishes to be covered. While this seems like a bargain at only $168 a month a person trying to live on $8900 annually it is an impossible hurdle.

With the ACA it seems that his income puts him into the medicaid bracket since he cannot afford insurance and his income is so low. Missouri however is refusing to expand the medicaid program under the ACA so it would seem he is left with the same choice. Pay $168 a month or live without any type of medical coverage. To make matters worse it seems he will be required to pay a $95 annual fee in 2014 which more than triples in 2015 and continues to increase each year for not being insured. If the information that I have gathered is correct it would seem the ACA will in fact make his situation worse and not better. I thought it was about helping those that could not afford health care and not increasing their financial burden?

My question to the community: is my understanding correct or do I have something wrong?

Exactly what is your Father's age? I'm 70 and I have some real-world experience. Also, exactly what is his exact monthly SS check? I'll try to give you useful answers.
 
You would think so but it is not the case. The month he started to receive his SS they told him that under federal guidelines he was no longer eligible for free medicaid. He had to chose one or the other. They also cut his food stamps to $16 per month (from $200ish). I guess they think $8900 annually is enough for a person to take care of themselves.

I'm asking about Medicare, not Medicaid. I thought that most of the elderly social security recipients were eligible for Medicare. Maybe I'm mistaken.
 
Exactly what is your Father's age? I'm 70 and I have some real-world experience. Also, exactly what is his exact monthly SS check? I'll try to give you useful answers.

$997 gross $749 after they deduct back taxes and penalties. Age is 63.
 
I'm asking about Medicare, not Medicaid. I thought that most of the elderly social security recipients were eligible for Medicare. Maybe I'm mistaken.

Oh I am sorry my mistake. He is not eligible for Medicare until age 66. At that point he will have to pay (he said) one hundred something a month which is deducted from his SS payment.
 
This is how I understand it.....

If a state doesn't set up an insurance exchange the federal government will do it for them.

If your father pays for a policy from the ACA insurance exchange and with his income so low, he could qualify for enough tax breaks that his insurance would be free. There isn't an annual fee if he's paying for his insurance.

Also, I think there will be advisors available on the insurance exchange that will help and guide people to what best suits their needs.

But like Lizzie said, if your father is collecting SS he's probably already on Medicare. But there he also has a choice of supplemental insurance policies through a program called Medicare Advantage. Again with his SS income so low he might qualify for a program on Medicare that covers his drugs for the low cost of a co-pay or something like that.

But really, I think you need to do a bit more research and/or find an advisor to help you. The SS or Medicare website is probably a good place to start.

edit: nevermind, I thought your father was older and qualified for Medicare. Good luck to you and your dad and I hope it all works out for you.
 
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$997 gross $749 after they deduct back taxes and penalties. Age is 63.

The $997 unfortunately takes his income past Medicaid. My ex-wife got a raise to $930 last year and bang - there went her Medicaid.

Is your Father disabled? I'm trying to understand why he took SS so early. At 65, he'll get Medicare which is a pretty good deal (or has been anyway.

Depending on his health condition, he might just go without insurance for the next 2 years. There are charity solutions and if he has no assets, what difference does it make if he goes to the ER and just never pays his bills. If his health is poor, he should at least try for disability.

I'm sorry I don't have more useful advice. I assumed your Father was older than 65 and I can't even pretend to understand ACA.
 
The $997 unfortunately takes his income past Medicaid. My ex-wife got a raise to $930 last year and bang - there went her Medicaid.

Is your Father disabled? I'm trying to understand why he took SS so early. At 65, he'll get Medicare which is a pretty good deal (or has been anyway.

Depending on his health condition, he might just go without insurance for the next 2 years. There are charity solutions and if he has no assets, what difference does it make if he goes to the ER and just never pays his bills. If his health is poor, he should at least try for disability.

I'm sorry I don't have more useful advice. I assumed your Father was older than 65 and I can't even pretend to understand ACA.


He had a massive heart attack at age 60 that severely damaged his heart. His last check up he had 32% functionability. As you can imagine this has had a great impact on his health and his ability to work. He tried for two years to get disability and was refused both times. The first time was the pretty standard first time decline that most go threw. The second time they looked at his work history and said [paraphrase] "We see you were a truck driver, you should be able to drive a truck even in the shape you are in. Driving a vehicle takes little effort" He then tried to explain to them that the DOT would not allow him to drive because he failed the medical requirements during his physical. They told him to reapply...

At that point his savings were running out and all other options seemed out of reach so he decided to take his SS early.
 
He had a massive heart attack at age 60 that severely damaged his heart. His last check up he had 32% functionability. As you can imagine this has had a great impact on his health and his ability to work. He tried for two years to get disability and was refused both times. The first time was the pretty standard first time decline that most go threw. The second time they looked at his work history and said [paraphrase] "We see you were a truck driver, you should be able to drive a truck even in the shape you are in. Driving a vehicle takes little effort" He then tried to explain to them that the DOT would not allow him to drive because he failed the medical requirements during his physical. They told him to reapply...

At that point his savings were running out and all other options seemed out of reach so he decided to take his SS early.

There are attorneys that will take a case like his on spec. Might be worth exploring.

One of my cat ladies can't get disability either. 2 years of runarounds and reapplying. Interesting that the frauds get it and the legit ones don't. Truly incompetent USG.
 
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