An honest question about ACA.

I've got a question for those who support the ACA. Please bear with me as this post is a bit wordy but please, if you want to respond, read it.I've spent quite a bit of time reading through a number of opinions, horror stories and news articles both in support of and in opposition of the Affordable Care Act (Obamacare for some). I will start out by saying that I don't really care for it, because I feel that it was pushed through congress in a manner that made me feel distinctly uncomfortable. It struck me as a group of people desperately trying to get a house cleaned before company showed up. Things always wind up in the closet that, if opened, can be very embarrassing.

What prompted me to make this post was a conversation I had with my Sister-in-Law. She is a single mom of 2 teenage children with a low paying job (I think she makes less than $20k a year). She is on all sorts of government assistance from Tanif to Section 8 housing allowance. She even get's a subsidized smart phone that's better than mine (not subsidized by the way). I asked her how much her premiums were going to be under the affordable care act, thinking that she would be one of the people who would be quick to sign up. Not because she's poor and single, but because she's my sister-in-law and that's what she said she was going to do last summer. Imagine my surprise when I discover that she didn't sign up. Even more so was the reason she gave.

Right now, both of her children are covered under a plan called Soonercare. It's a state funded insurance for low income children who's parents qualify for any public assistance. The co-pay is $0 and the the premium is 0$. She went onto the federal site to sign up, since Oklahoma does not have a state exchange, and went through all of the forms to sign both herself and her children up. Her total, under the ACA would be a monthly premium of $260 ($80 for each of her children and $100 dollars for her) These were the numbers she gave me so I can't actually attest to the accuracy of them but they were the ones she mentioned.

She chose not to sign up for coverage because "my children are already covered for nothing. Why am I going to pay for them? It wouldn't let me keep Soonercare if I signed up for Obamacare. I had to sign them up too." I don't know if this was valid but it's what she told me. She also told me that the fine for her not signing up was going to be somewhere around $700 at tax time and that she could afford it since she got back just above $10,000 dollars this year. Yes, my eyes bugged out since I had to pay about $300 this year myself. She said that there wasn't any reason for her to sign up and have to pay that much money when she could just pay at the end of the year.

My question is this. For those who support the Affordable Care Act, what would you say to someone in my sister-in-law's position to get her to sign up? Confronted with the same choice, would you?

I don't think there are any motivating factors that would compel your sister-in-law, and millions of others like her, to sign up for A.C.A.
This is a fundamental flaw in the A.C.A.

I know the question is posed to those in support of ACA. I don't know if I have an opinion either way because it has not directly effected me yet. Just replying anyway...
I'm not sure what I would say, if anything. She is doing what is legal in your state so I don't see anything wrong there. It certainly doesn't seem fair to some people who are having to sign up for the ACA and pay a premium. Some of the employees at the company that I work for went through a terrible thing last year. A lot of employees "lost" their insurance because it did not meet the requirements. They lost it as of Dec. 31 2013. Those of us in administration type positions kept our BC/BS because it did meet the requirements. I work primarily (really) to afford health insurance for my kids. No kidding, it is just about every penny!
The employees that lost their benefits had to either sign up or face paying the premium for ACA until the company can get it together and come up with something that they can provide by I think it is July 2015 maybe or they risk being fined...It is a company of around 300 people so I guess maybe 50 still have BC/BS so I'm guessing the fines could be steep.
If she were to sign up and pay that $260 per month premium, she may need more public assistance and help from her family just to meet the basic needs. It seems like a double edged sword. Would you be willing to help her out? Financially that is if she had to pay the money?


Peace

reply to post by rickynews


Rickynews, you have a private message. Click on the "envelope" icon at upper-right corner.

Thanks for the post so far. As for the question of if I would help out my sister in law if she needed more so as to afford coverage for the kids, If they didn't have something already, I would consider it. If nothing else, maybe helping to pay the premiums. I love those kids and I really don't want to see anything bad happen to them.

My understanding is that the ACA is primarily designed to fill gaps for middle-income people impacted by high insurance rates and for lower income people through expanded (or not) state/federal medicaid and CHIP programs.

For example, in my state, If someone is above the Medicaid level (up to 200% of the poverty level), but still "low income" there is a program for children to have extremely low cost health insurance (a CHIP program). If your family qualifies in this income bracket then your children are automatically sent to apply for CHIP rather than allow you to sign up through the ACA, just as it will send you to sign up forMedicaid if you are at that level of income.

The ACA marketplace is for those who have no other option than to purchase individual/family plans on their own, who cannot get insurance through their work, an organization (ie union), and who do not qualify for previously established or expanded state/federal programs.

I'm guessing that your sister would not be allowed, due to the rules, to purchase insurance through the ACA, unless her income increases.

I know this doesn't help you with your sister. I just don't think there actually is a way for someone in her position to purchase through the ACA marketplace without first having been denied coverage through Medicaid and/or CHIP. I would recommend that you find an "ACA Navigator" volunteer in your area, or talk to an insurance broker in your state to see what your sister would need to do.

peace,
AB