These Millionaires Get Obamacare Subsidies

 
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This one weird trick can help even rich people buy Obamacare at sharply reduced prices. Really.

A number of wealthy individuals, some of whom were “disgusted” with Obamacare when it first went into effect, nonetheless are now taking advantage of federal financial aid available under that health-care law to help significantly reduce their monthly insurance premiums.

Carolyn McClanahan, a Jacksonville, Fla., financial advisor and medical doctor, told CNBC that she’s steered at least five such clients, whose individual net worths range between $1 million and $3 million, toward buying Obamacare health plans because of the federal subsidies available due to their taxable income levels.

Those clients are saving between $4,600 and $8,800 in annual premium payments as a result of subsidies. On top of that, McClanahan said, those customers are getting extra financial help to pay their out-of-pocket health expenses — the copayments, coinsurance and deductibles that aren’t covered by their insurance plan.

The idea of giving rich people discounted Obamacare plans raises the eyebrows of even McClanahan’s clients, who were initially skeptical when she described the option.

“Everybody was like, ‘Are you sure this is going to work?'” McClanahan said of her clients’ reaction.

“And I’m like, ‘Yes, I’m sure it’s going to work.'”

And it’s legal as well, because of the way the Affordable Care Act focuses on income rather than net worth to establish eligibility for Obamacare aid.

“The law was set up that way, so I’m going to help them take advantage of it.”

The ACA was enacted primarily to help uninsured people get health coverage at a price they could afford. To help do that, the ACA authorized the federal government to issue tax credits, or subsidies, to people with low or moderate incomes who buy health plans sold on government-run Obamacare exchanges.

For 2016, individuals with annual taxable income between $11,770 and $47,070 qualify for such aid.

McClanahan’s Obamacare customer clients were all retirees who stopped working before they were 65 years old. They no longer had the option of getting health insurance through their jobs, and were too young to qualify for Medicare, the federal health insurance program for senior citizens.

Those people, while having relatively high net worths due to investments and real estate, also were in a position to have taxable income that was low enough to qualify for Obamacare subsidies.

But that income could still be high enough to keep them above 100 percent of the poverty level. If their incomes fell below that, they would not qualify for the subsidies to help buy private plans, and also would not qualify for government-run Medicaid because Florida rejected expanding that program to cover more low-income people.

McClanahan said she helped the clients structure their income stream — and the taxable component of it — “just right.”

“The first thing you’ve got to figure out is how much money do they need to live on,” she said.

The clients, all of whom had paid off their homes, needed “anywhere between $5,000 and $7,000 a month” to live on, she said.

Helping that strategy was the clients’ use of bond ladders, which gave them steady income as the bonds matured over time, and also spun off interest payments from the bonds’ coupons. While the interest payment is taxable, the initial investment in the bonds is not, McClanahan noted.

“For most people, we’re aiming for like $18,000, $19,000 in income” that is taxable, she said.

That level of income also was low enough that all of the clients qualified for the added Obamacare aid of “cost-sharing reductions,” which are available to people with taxable incomes below about $29,000 who enroll in so-called silver plans. Without cost-sharing reductions, silver plans cover about 70 percent of customers’ medical expenses, with the balance owed out-of-pocket by the customer.

Angie Koury Lieb, a Jacksonville insurance broker, helped McClanahan’s clients get into those plans, which in Florida are sold on the federally run Obamacare exchange HealthCare.gov.

Lieb said that some clients initially “were pretty disgusted about the subsidies and how it all works” when Obamacare first began taking effect.

“I think a lot of it was very politically motivated, that they didn’t necessarily agree with the Affordable Care Act itself,” she said.

“Then they said, ‘Well, shoot, I’m going to try to qualify myself,'” Lieb said. “I think they were more, ‘If I can’t beat them, join them.'”

Lieb said that when she helped McClanahan’s clients sign up on HealthCare.gov and pick their plans, “they were usually pretty pleased and excited” when they saw how much subsidies they would be getting to lower their premiums.

On the lower end of the prices, one client qualified for a $423-per-month subsidy, which reduced the price of their plan from $663 per month down to $240 per month, she said. On the high end, another client qualified for a $737 subsidy, reducing their premium from $1,172 per month to $435.

And “with the cost-sharing reduction, I think people were extremely happy,” Lieb said. “It reminds people of what health insurance looked like 25 years ago, when they had a $10 copay and no deductible.”

Lieb and McClanahan both noted the fact that their clients, due to their financial position, came under scrutiny from the government when they applied for their subsidies. To obtain those subsidies, customers have to indicate how much income they expect to earn in the coming year.

Every client, McClanahan said, was flagged for review of their subsidy eligibility when they applied because tax forms revealed they previously had high incomes.

“We had to provide a lot of supporting documentation,” McClanahan said.

Clients also must be conscientious about reporting income changes during the course of the year. If people end up earning more than they had estimated when they applied for their subsidies, they could end up owing some or all of the subsidy back when they file their tax returns the following year.

Written by Dan Mangan of CNBC

(Source: CNBC)

Obamacare is Actually Not So Affordable — Unless You’re Broke

© Michael Jung/Getty Images
© Michael Jung/Getty Images

It’s time for the Affordable Care Act to join a long list of oxymorons. Why? Because rather like “military intelligence,” “cat proof,” “government organization,” and “simple calculus,” the law better known as Obamacare turns out to be an inherent contradiction. For a sizeable part of the population, anyway.

The ACA is just not affordable to a big chunk of those it was most meant to serve: The previously uninsured. In fact, many are worse off than before, according to a new study. That fact could also unravel part of the program’s foundation, which could be a problem for healthcare insurers.

“Many of the non-poor formerly uninsured are estimated to be worse off,” than without insurance, according to a September-dated working paper from the National Bureau of Economic Research titled “The Price of Responsibility: The Impact Of Health Reform On Non-Poor Uninsured.”

How so? The subsidies are not large enough to offset the cost of the insurance premiums and the fact that many previously uninsured will now have to pay part of the cost to see a doctor, the report explains. The authors reached that conclusion after reviewing data for the uninsured prior to Obamacare, including age, gender, earnings and location. Then, they married that information with health-care expenditures for the group and used it to make estimates of out-of-pocket costs before and after the law went into effect.

The group of people whom the authors highlight are the non-poor, or those ineligible for Medicaid but who maybe eligible for various subsidies for premiums or cost-sharing, depending on their income level. It turns out that the more someone earns the worse off they’ll be.

“At higher income levels, small or zero subsidies and currently modest penalties will not be enough to affect the large welfare losses that the middle class uninsured experience were they to buy coverage,” the report says. Those in good health were “consistently worse off from purchasing coverage regardless of the assumptions made,” according to estimates calculated by the researchers.

Is this the fault of healthcare insurers like AetnaUnited HealthcareCigna, or Anthem ? Not really. It’s just the way the law is designed. Will it mess up their actuarial calculations? Probably so, because an important demographic of healthy people may simply not buy coverage.

“Most uninsured will lose and, according to our estimates, will prefer to remain uninsured at the current penalty levels for violating the individual mandate,” the report continues.

Ultimately, people will do what is in their own best interests. In this case, many individuals who realize that signing up for healthcare insurance is a losing proposition financially simply won’t do it.

In this case, it will be those with higher incomes and better health — the population insurance companies need in order for their actuarial assumptions to work.

What happens if the healthy don’t sign up? Either the insurance companies stand to take a loss because overall claims are larger than the revenue from premiums and subsidies, or they raise premiums, making it even more unlikely that the healthy will sign on.

The big question now: Who will bear the financial brunt of this problem, the people buying or the insurance companies or both?

Written by Simon Constable of TheStreet

(Source: TheStreet)

What the Obamacare Court Ruling Means for Consumers

© webphotographeer/Getty Images
© webphotographeer/Getty Images

Millions of Americans just got to keep their health insurance, as the Supreme Court ruled earlier today in a 6-3 decision for the government in the  King v. Burwell Obamacare case.

The case considered the highly anticipated challenge to whether the IRS can issue insurance subsidies for individuals enrolled on the Affordable Care Act federal exchange. In doing so, the Court upheld President Obama’s signature achievement for the second time, allowing the law to escape what many viewed as a potential disaster.

In the words of Tim Westmoreland, a law professor at Georgetown, the latest challenge to the Affordable Care Act has ended in one big case of “never mind.”

The lawsuit focused on specific language from the Affordable Care Act’s Definitions section, which says that subsidies shall be made available to individuals who enroll in exchanges “established by the state.” Under the plaintiff’s plain-meaning argument, this word choice should preclude subsidies for anyone except those enrolled on state-based insurance exchanges, specifically the federal exchange Healthcare.gov.

The Court rejected this interpretation, along with the plaintiff’s argument that this language was built into the law intentionally to coerce states into setting up their own exchanges at the risk of losing access to federal subsidies.

The coercion argument, Westmoreland said, was particularly weak.

“Other than some highly rhetorical comments by Johnathan Gruber, I know of nothing that would suggest that Congress intended to do that,” he said. “The idea that they would put a gun to the states heads on page 113 in the Definitions section is just nuts… It’s in the definition of the term ‘coverage month.’ Who would ever look there to find the doomsday machine?”

According to research by the Kaiser Foundation, at stake in this decision were subsidies for more than 6.3 million people across the 34 states that haven’t set up their own exchanges. Many health care experts, wuch as the Urban Institute’s Matt Buettgens, predicted nightmare scenarios for the insurance marketplace at large in the wake of an adverse ruling. He suggested that the fallout from such a decision would have left more than 8 million people uninsured.

“We could see drastically decreased enrollment, and those remaining enrolled could see a much higher cost than average,” he said, speaking before today’s ruling on a possible adverse decision. “We could see large increases in costs of premiums, and because we would see many more people uninsured we would also then see much more uncompensated care that federal and state governments would end up paying for.”

“There are examples of premium death spirals that have actually occurred,” Buettgens added. “This would be an accelerated version of that because most of the enrollees would be hit immediately with increases once their tax subsidies go away, so that would jump start the process.”

Today’s ruling for the government will leave the system more or less in place, allowing subsidies to continue uninterrupted for enrollees on the federal exchange.

For the time being, it looks as though this may end the significant legal challenges to Obamacare, said Westmoreland of Georgetown. The only outstanding issue is a case challenging the constitutionality of the Independent Payment Advisory Board, which is unlikely to proceed due to the fact that the Board has not yet made any decisions.

Westmoreland cautioned about over-confidence on the part of the Obama Administration, however, pointing out that few in the legal community foresaw the potential significance of King either.

Written by Eric Reed of The Street

(Source: The Street)