Millions of Americans still fall into the no-health-insurance gap. They earn too much to qualify for Medicaid in their state but not enough to afford ACA (Obamacare) health insurance policies — even with the recently increased subsidies. Many are unaware that they now qualify for a 100% subsidy — basically free insurance — if they enroll.
The government is now offering a new, year-round special enrollment period for people who earn between 100 and 150% of the federal poverty level, which is too much to qualify for their state Medicaid program. They can sign up now for a zero-premium ACA, even if they missed last winter’s open enrollment period.
Health insurance in America
The vast majority of Americans get their health insurance though work — or, in the case of seniors, through Medicare. Employees get some choices in coverage and costs, with many opting for high-deductible plans combined with pre-tax health savings accounts.
Those enrolled in Medicare have a choice between the traditional Medicare, which carries monthly premiums based on income, and Medicare Advantage plans, which may have low or zero monthly premiums in exchange for managed care restrictions and networks.
Every year, I write about the December special enrollment period (SEP) that allows small businesses to set up pre-tax health insurance coverage without employer contributions.
And for those who don’t get health insurance at work, Obamacare came along to offer more affordable individual plans with premium subsidies. Currently, more than 14.5 million Americans receive health insurance through the ACA benefits. Still millions don’t have a health insurance policy and can’t get Medicaid in their state of residence.
Today’s column is directed at low-income people who might sign up for an ACA policy — if they knew they could enroll right now and pay zero premiums!
Low-income 100% Obamacare subsidies
As of March 21, 2022, there is a new year-round special enrollment period for these free (zero premium) ACA policies. This 100% premium subsidy is intended for people who earn too much to qualify for their state’s Medicaid program but less than 150% of the federal poverty level.
The calculation of eligibility for this 100% premium subsidy is based on location, income and the number of people in the household.
Healthinsurance.org has created a simple calculator to figure out if you — or someone of low income whom you might know — is eligible for this free health insurance.
Just go to www.healthinsurance.org/FPL to input your information on income, state, and number of people in your family. You will instantly see if you might be eligible for a zero-premium policy.
Here’s an example. According to the calculator at www.healthinsurance.org/FPL, in Chicago, a single parent with two young children, who earns $31,000 a year would find herself at 143% of the Federal Poverty Level. So, she would qualify for a FREE ACA policy. If her income rises to above roughly $33,000, she will have to pay a small monthly premium.
If you qualify, the next step is go to the “Obamacare” website — www.HealthCare.gov — to search for a policy. Residents of some states may be directed to their state-run website for coverage. Note: in many states, children are covered by CHIP (childrens’ health insurance plans), while the parent may qualify for this free ACA plan.
There are some exceptions. Unbelievably, 11 states have not “expanded” their Medicare coverage in a dispute with the federal government. In those states, people who earn less than 100% of the Federal poverty level may get no state Medicaid coverage.
In America, we have chosen to stick with a system of health insurance coverages, instead of opting for a free national healthcare policy. That’s a debate for another place. But if we are going to offer affordable — and in some cases free — health insurance policies, let’s make sure everyone understands this new, unrestricted, year-round opportunity to access these free policies.
If you know someone who might qualify with income above their state Medicaid level, but below 150% of the federal poverty level, send them to Healthcare.gov to search for their free health insurance policy. You’ll sleep better, and so will they
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