IRS forcing workers to insure their spouses

IRS forcing workers to insure their spouses (Full Version)

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defiantbadgirl -> IRS forcing workers to insure their spouses (8/27/2013 4:15:52 PM)
I thought there was no law that said workers had to insure their spouses, so if a worker refused to insure his/her spouse, the uninsured spouse would be eligible for subsidized coverage on the health care exchange. This article strongly hints that workers will now be required by law to insure spouses if their employer allows it. What if the couple is low income and can't afford medical care because they can't afford a $4000 deductible + 20%? What if one spouse has a chronic health condition that requires expensive care? In states that refuse to expand Medicaid, will low income couples in this situation have to choose between health care and divorce? Changing jobs is extremely difficult with the current job shortage in the United States. "The IRS, which is administering parts of the law involving revenue collection, released the final rules spelling out the details of what constitutes minimum essential coverage, and how individuals are responsible for spouses, children and other dependents, among other topics." article: http://news.yahoo.com/irs-issues-final-rules-obamacares-individual-mandate-210532716.html

DomKen -> RE: IRS forcing workers to insure their spouses (8/27/2013 4:25:36 PM)
The rules are for the individual mandate which is the part of the law saying a head of household must cover everyone in their household or pay a penalty. It does not specify anything about employer health coverage. Here is the actual rule https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-21157.pdf

defiantbadgirl -> RE: IRS forcing workers to insure their spouses (8/27/2013 5:27:39 PM)
quote: ORIGINAL: DomKen The rules are for the individual mandate which is the part of the law saying a head of household must cover everyone in their household or pay a penalty. It does not specify anything about employer health coverage. Here is the actual rule https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-21157.pdf I know employers aren't required to cover spouses, but if employers do offer coverage to spouses and the IRS forces the employed head of household to cover everyone, a low income worker with a $4500 deductible (a deductible that high is allowed for a family under the new law) policy can't refuse to cover a spouse without paying a fine which will be extremely high by 2016. Insured low income Americans with expensive to treat conditions can't afford health care and/or medications with a $4500 deductible. Low income people with subsidized coverage on the exchange can pay $50/month premium, have no deductible, and a $3 co-pay. In that situation can you see why it would be in that person's best interest for their spouse to refuse to insure them under a high deductible employer based policy and for them to enroll on the exchange so they could get the care they need? If the law prevents this, it seems the only options are continuing to go without needed care, trying to find another job during a job shortage , moving to a state that's expanding Medicaid, or if barely above 138% of the poverty level getting a divorce so that person is no longer a family member (spouse).

tazzygirl -> RE: IRS forcing workers to insure their spouses (8/27/2013 6:05:43 PM)
quote: Low income people with subsidized coverage on the exchange can pay $50/month premium, have no deductible, and a $3 co-pay. Where did those figures come from?

DomKen -> RE: IRS forcing workers to insure their spouses (8/27/2013 6:14:37 PM)
quote: ORIGINAL: defiantbadgirl quote: ORIGINAL: DomKen The rules are for the individual mandate which is the part of the law saying a head of household must cover everyone in their household or pay a penalty. It does not specify anything about employer health coverage. Here is the actual rule https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-21157.pdf I know employers aren't required to cover spouses, but if employers do offer coverage to spouses and the IRS forces the employed head of household to cover everyone, a low income worker with a $4500 deductible (a deductible that high is allowed for a family under the new law) policy can't refuse to cover a spouse without paying a fine which will be extremely high by 2016. Insured low income Americans with expensive to treat conditions can't afford health care and/or medications with a $4500 deductible. Low income people with subsidized coverage on the exchange can pay $50/month premium, have no deductible, and a $3 co-pay. In that situation can you see why it would be in that person's best interest for their spouse to refuse to insure them under a high deductible employer based policy and for them to enroll on the exchange so they could get the care they need? If the law prevents this, it seems the only options are continuing to go without needed care, trying to find another job during a job shortage , moving to a state that's expanding Medicaid, or if barely above 138% of the poverty level getting a divorce so that person is no longer a family member (spouse). One more time the rules issued today are about who will have to pay the fine for not getting insurance and what qualifies as coverage. there is nothing about denying a persons access to the exchanges. Your state, or the feds, are setting up the exchanges and info should be available on the web or through some sort of social service organization.

defiantbadgirl -> RE: IRS forcing workers to insure their spouses (8/27/2013 7:04:45 PM)
quote: ORIGINAL: tazzygirl quote: Low income people with subsidized coverage on the exchange can pay $50/month premium, have no deductible, and a $3 co-pay. Where did those figures come from? http://finance.yahoo.com/news/obamacare-subsidies-much-100400152.html?bcmt=comments-postbox "To get a better idea of the subsidy amounts, take a look at California, where a 40-year-old can buy the second-cheapest silver plan for $294 a month. If that resident made just under $17,235, he would get a subsidy of $236 and pay a maximum of $57. That person would also have no deductible and pay only $3 for primary care visits because he is getting additional subsidies to minimize his out-of-pocket costs." Okay it's $57 not $50, that's for California not Kansas, but everything in California is usually much more expensive than in Kansas. In that article, there is a Kaiser calculator link for calculating subsidies. I entered annual incomes of $21,000, $15,000 and $10,000 for a household of 2 insured through an employer to see what the results would be. The results were the same on all 3 of those incomes. Eligible for Medicaid if in a state that expanded it. Employee ineligible for subsidies unless premium is more than 9.5% of income. So even a person with a low enough income to qualify for expanded Medicaid can be ineligible for health insurance subsidies. Even though the spouse isn't the employee, the IRS says the head of household has to provide health insurance for all family members (info for that in my first post) or pay the fine which will be extremely high by 2016. How could a low income household afford employee premiums, exchange premiums, and the fine? I called the phone number on the healthcare.gov website and was asked by the person I spoke with what calculator I got my information from. When I told him it was the Kaiser calculator, he said that was the correct calculator to use. I was told that's the same calculator they are recommending other people who call them to use.

defiantbadgirl -> RE: IRS forcing workers to insure their spouses (8/27/2013 10:00:55 PM)
quote: ORIGINAL: DomKen The rules are for the individual mandate which is the part of the law saying a head of household must cover everyone in their household or pay a penalty. It does not specify anything about employer health coverage. Here is the actual rule https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-21157.pdf Here is another older article that explains what I'm talking about: http://calwatchdog.com/2013/02/05/obamacare-grants-exemptions-for-everyone-but-taxpayers/ "The law now says that, as long as an employer keeps the employee’s portion of his single health care premium below 9.5 percent of the employee’s annual salary, such a portion is deemed “affordable.” “All that a company has to do is make sure the health coverage is somewhat affordable for the employee, but the rest of the family is out in the cold,” Gottwals said. OBAMACARE UNFRIENDLY TO SPOUSES Without being included in the employer’s contribution, the family health-care insurance coverage will be off the chart, leaving the spouse and kids to fend for themselves. He added, “Furthermore, if the employee’s premium is deemed ‘affordable’ because it is below 9.5 percent of the employee’s W-2 wages, the non-working spouse and children will be denied access to federal subsidies to buy healthcare in the Exchanges. Hence, if the employer offers ‘unaffordable’ coverage to the spouse and kids, the spouse and kids are precluded from federal assistance.” In a peculiar twist, earlier Obamacare regulations mandated that employers offer coverage to children, but declined to mandate that spouses be offered dependent coverage. For employers unwilling or unable to contribute to spousal healthcare, a family will be better off if the employer does not even offer healthcare to spouses at all. This is because, if the spouse is not offered healthcare, he or she can actually get a federal subsidy to buy coverage in an Obamacare exchange. Whereas, if the spouse is offered “unaffordable” coverage by an employer, the spouse is denied federal subsidy assistance. Employers are not mandated to cover spouses on insurance under Obamacare. So if an employer offers insurance for spouses, they are ineligible for the subsidies that would make health insurance and health care affordable. The only way spouses of employees with health insurance can get subsidies is if the employer doesn't cover spouses. Even if the employer decides to stop covering spouses, they can probably only apply that to new hires because of the grandfather clause, right?

DomKen -> RE: IRS forcing workers to insure their spouses (8/28/2013 12:16:45 AM)
You're going to have to either read the published rules and figure it out or find someone who has and get the info from them.

defiantbadgirl -> RE: IRS forcing workers to insure their spouses (8/28/2013 12:33:56 PM)
quote: ORIGINAL: DomKen You're going to have to either read the published rules and figure it out or find someone who has and get the info from them. Just an update: On the link you posted, I found a phone number to call with questions. I called that number and the person I spoke with knew more about the health care law than the agents at the phone number listed on the healthcare.gov website. In fact, he seemed to be an expert on it. According to him, if an employer offers family coverage, the spouse and/or children are NOT eligible for subsidies. So it is possible for a family to have an income low enough to qualify for expanded Medicaid (in participating states) yet be ineligible for health insurance subsidies. They do have the choice of purchasing unsubsidized health insurance on the exchange, but that would likely be even more expensive than employer based coverage. I really wanted to be wrong but unfortunately, I wasn't. Thanks for the link.

tazzygirl -> RE: IRS forcing workers to insure their spouses (8/28/2013 8:45:18 PM)
Typically those who work low income jobs get insurance plans like Day One. Trust me, they arent better off with that piece of crap. Its cheap, its from the day of hire, and most have a 1000 cap... and you have to jump through paperwork hoops to get them to pay.

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