By Stephen Tweed
How is the Affordable Care Act affecting you, your family, and your home care business?
In a speech in Flint Michigan earlier this week, former US President Bill Clinton commented on what he sees is wrong with the ACA.
“While the current system works fine for lower-income people, and while 25 million more people now have health coverage, other people are seeing their premiums doubled and coverage cut in half. The people that are getting killed in this deal are small business people and individuals who make just a little too much to get any of these subsidies,” he said. “Why? Because they’re not organized, they don’t have any bargaining power with insurance companies, and they’re getting whacked.”
He later said: “It’s the craziest thing in the world.”
That’s what we are seeing in the home care business world. Owners of home care companies are “getting whacked” with higher premiums, higher deductibles, and worse health care coverage for their own families. Their office staff members are paying a higher share of their own premiums for worse coverage. And most caregivers are either on Medicaid, or go without coverage because the can’t afford or choose not to pay the premiums, deductibles, and co-pays.
One major criticism of the health law has been a marked rise in premiums for 2017. Individuals can buy their insurance on the individual market as well as on the ACA’s exchanges. Those who are eligible for subsidies can only get them on the ACA’s exchanges. The subsidies help offset the cost of the higher premiums.
That leads to a situation where millions of people will pay more for coverage next year, while those who qualify for subsidies will largely have their premium increases absorbed by the subsidies. However, this system creates big problems for home care workers when their company offers a Bronze level plan and they decline it. The caregiver can’t afford the premiums, but if they decline the coverage offered by their employer, they cannot qualify for a subsidy on the exchanges. They must also pay the individual penalty to the IRS when they pay their taxes. Usually, it shows up as them not getting the tax refund they were used to getting.
IRS Sending Notices
The other effect we are hearing about this fall are home care CEOs who report getting non-compliance notices from the IRS. Caregivers who were offered coverage last year by their employer declined the coverage. Then on their 1040 or EZ1040 tax form, they were asked if their employer offered “affordable care”, and they check the box “NO.” The IRS is just getting around to checking on tax returns filed in April, and are sending notices to employers. The employer then has to appeal the claim and file paperwork to prove that they did, in fact, offer affordable health care under the law.
Now the caregiver has to pay the individual penalty for not having insurance.
President and Mrs. Clinton Support Medicare and Medicaid for ALL
Mr. Clinton then argued in favor of his wife’s position that more Americans who don’t qualify for subsidies be allowed to buy into Medicare and Medicaid to get coverage. Our research shows that there are a significant number of folks in Washington DC who believe in a single payer health system like those found in Canada, Europe, our Australia.
What do you think?
What are you experiencing?
How has the ACA affected your business and your family?
With all of the challenges presented by the rising cost of health care, the rising cost of insurance, and the problem home care workers have in affording coverage, what should the next step be?
