Getting the facts out on Obamacare

With the deadline for open enrollment approaching, Upper Des Moines Opportunity is looking to educate community members about the Affordable Care Act.

UDMO hosted an Affordable Care Act workshop on Monday night at Kendall Young Library. The workshop leader, Tawnta Staten, is one of three specialists hired by UDMO to share information about the law in 12 Iowa counties. Staten said the workshop fits with UDMO’s goal of helping people with low incomes.

“A lot of people don’t know if they qualify. A lot of people also don’t know that there’s a deadline coming up or what options are available to them,” Staten said.

With information provided by the Iowa Insurance Division, Staten lead a half-hour presentation that covered many aspects of the ACA. She said the workshop helped simplify the financial and poverty guidelines and coverage options laid out in the bill.

The workshop was hosted two weeks before the open enrollment deadline on March 31. Those who don’t sign up or meet the minimum essential coverage guidelines will face a penalty in their 2015 taxes. Staten said some people think the fee is a flat $95. However, it’s more complicated and possibly more costly than just that.

According to the government health care marketplace website, the penalty for not having insurance coverage is calculated in one of two ways. An uninsured person would either have to pay one percent of their yearly household income, only the amount of income above the tax filing threshold with a maximum penalty costing the national average yearly premium for a health care marketplace bronze plan, the lowest premium plan, or $95 per person or $47.50 per child for the year with a maximum penalty per family of $285. Whichever fine is higher will be charged.

The penalties also increase every year. In 2015, it’s two percent of income or $325 per person. In 2016, it’s 2.5 percent or $695 per person. After that, penalties are adjusted for inflation. Those uninsured for part of the year, 1/12 of the yearly penalty applies to each month they are uninsured. Those uninsured less than three months are not penalized. However, those three months are close to passing. According to Internal Revenue Service information on the ACA, people and their families must have health care coverage starting in January this year. Any penalties that would have to be paid would apply to 2014 tax returns.

The ACA also makes exceptions. The health care website says those on medicare or medicaid meet the minimum essential coverage requirements and would not have to pay a penalty. People can also apply for hardship exceptions from coverage. Those who might qualify for an exception include people who are homeless, those who experience domestic violence, and people who had their individual insurance plans cancelled and believe other marketplace plans are unaffordable, among others.

While the ACA can cause penalties, Staten said there are good things about it as well. She said online marketplace plans offer substantial tax incentives. The premium tax credit, according to the IRS, is an advanceable, refundable tax credit that was made to help those eligible with low to moderate income afford health care insurance bought on the online marketplace.

When applying through the marketplace, it will estimate the amount of the premium tax credit that those applying may be able to claim for the tax year. The income guidelines for obtaining the credit are between 100 percent and 400 percent of the federal poverty level. Staten said that with those guidelines, a family of four with between $23,550 and $94,200 of yearly income may be eligible for thousands of dollars in tax refunds.

Additionally, Staten noted that people could not be denied coverage due to pre-existing conditions.

For more information, Staten said navigators and assistors can be found at localhelp.healthcare.gov. She said there are a few people at Van Diest Medical Center who can help community members sign up for a plan on the marketplace. She also said a toll free, 24-hour phone line can be contacted to sign up at 1-800-318-2596.