[quote=no_such_reality]Same issue with the under 25 crowd. Not sure what the complaint is other than the State department is being incompetent in execution in checking out make sure the State isn’t getting bilked.[/quote]It’s not “their (State’s) money,” NSR. Healthcare subsidies come from Federal funds and it is actually the IRS who is “in charge” of vetting taxpayers’ incomes for subsidy eligibility and amount. The IRS has access to the forms of ALL income reported to each taxpayer because those paying entities are required to report this info to the IRS. CC does not.
NSR, why don’t you explain to me how a CC enrollee who received a tax refund in 2015 of a portion of CC premiums they paid in 2014 (because they were not awarded a large enough subsidy for their incomes by CC in 2014) was told by CC in writing DURING 2014 that they are NOT eligible for a subsidy (eligible only for Medi-Cal) and threatened with forced placement of their CC acct to Medi-Cal? OR, the CC enrollee was told by CC in writing that they were not eligible for a subsidy anymore during the same year that the IRS determined they didn’t receive enough subsidy for that year and refunded them premium monies after they filed their tax returns?
This debacle is happening again this year for early 2015 tax return filers. They’re getting $400 to $900 back from the IRS this year for not receiving enough subsidy from CC in tax year 2015, yet ALL have been hassled in writing by CC and/or Medi-Cal workers since the 3rd quarter of 2015 (and now, again, in 2016) to “re-prove” the SAME income to CC (or Medi-Cal) for “subsidy eligibility” which the IRS has already vetted! Lots and lots people over the age of 55 are on “fixed incomes” which change little from year to year unless they remove income from their retirement savings.
This whole “make-work procedure” by the state and counties is nothing more than a function of (greedy) state gubments overarching and sticking their noses into everyone’s business because they found loopholes in the ACA which they believe permits them to do so for the sole purpose of obtaining the right to eventual “estate recovery” on the estates of those CC enrollees receiving subsidies who are over the age of 55. In CA, it’s as if our 58 county SS agencies don’t have enough work with “poor” US citizens at their doors seeking cash and food aid as well as illegal immigrants to deal with who are attempting to use phony identities and addresses to receive aid.
It was a really “bad idea” to expand Medicaid/Medi-Cal in the states who adopted it and the predominately DEM Congress who passed this crap were idiots. The states who adopted “expanded Medicaid” are (very methodically and purposefully) attempting to snag thousands upon thousands of high-asset boomers into the their dragnets for the sole purpose of eventual “estate recovery.” The vast majority of these individuals are reporting legitimate incomes above (often far above) the Medi-Cal threshold which CC and their respective SS agencies then discount or render “exempt” in the back room (and unbeknownst to the taxpayer/CC enrollee) for the sole purpose of force-placing them on Medicaid/Medi-Cal behind their backs! For example, I will receive a portion of my sponsor’s military retirement every month for the rest of my life and the portion of my (non-taxable) Health Insurance Reimbursement from my retirement association every month until I am 65 (at which time my allowance will increase to pay for my Medicare supplements for Parts B and D). But both of those “monthly incomes” are exempt from keeping me from Medi-Cal eligibility! My experience with “the system” with the 7-8 people I have helped sign up to CC is that it is grossly incompetent and can’t understand numbers on tax forms indicating the individual has other lifetime income such as annuities or trust income, etc and will receive it until the “fund” runs out (which will likely be many years … in most cases, AFTER the individual turns 65). CC is also too incompetent to determine from a 59.5+ yo’s tax return that they removed tax-free $$ from retirement accts last year to live on.
This situation is especially difficult for boomers with CC accounts due to the now exorbitant cost of premiums of CC plans for their age group. Prior to the ACA, I knew several people over age 55 who purchased their own plans (incl myself) and no way did ANY of them pay monthly premiums of over $1000 until about age 62 (for a comprehensive plan, NOT an HDHP)! Now, HMO, EPO and PPO premiums are hitting the $1000 month mark starting at Gold level for age 56 for most of the CC plans (which is nearly 3x the cost of a very good pre-ACA HDHP). By the time one hits the age of 62, monthly premiums for Silver plans and up now cost from $775 to $1350 per month and are rising 8-20% per year in CA! I can tell you that the vast majority of boomers would rather not take a subsidy (and didn’t need one to pay for their coverage prior to the ACA) but the “ACA compliant” plans are now so pricey that many have no choice but to accept a subsidy if they wish to NOT outlive their retirement savings. The requirement that ALL plans now be “ACA-compliant” has driven up the price for those plans exponentially for this age group who typically doesn’t need or want a good portion of services which are “ACA compliant” (i.e. maternity svcs, chiropractic, mental health, drug and alcohol detox/rehab, svcs for autistic children, etc). Yet, by law, every CA resident who is NOT on Medi-Cal must now pay for ALL of these services every month in their premiums as they are mandatory inclusions in our coverage.
Boomers’ healthplan premiums are high enough. We shouldn’t be forced to subsidize millenial families having babies (while they pay premiums which cost 1/3 to 1/4 of ours). Who was there to “subsidize” our “maternity bills?” Ummm, actually, no one. We paid our own medical bills with our own medical coverage.
The ACA is the biggest scam this country has ever seen and the only entities benefiting from it are the insurance companies who opted to participate in the state exchanges. They are raking in billions from the gubment only to offer very narrow networks (and often no networks at all in some jurisdictions) to their sitting-duck state-exchange planholders in exchange for those billions. The ACA isn’t even good for millenials. Before it was enacted, relatively healthy individuals in their 20’s were able to easily obtain a NATIONWIDE HDHP with a very REPUTABLE carrier with a HUGE selection of providers on the open market for $94 to $110 month (30-somethings cost a little more).
As a result of the ACA, healthplan premiums are now so inflated that the majority without access to health insurance now need a “subsidy” to help pay for it every month. This phenomenon has the effect of creating a “license” for state and local gubment to insert itself into Joe and Jane 6p’s personal business. To this end, CA now needs more and more CC workers and County SS workers (who vest for lifetime pensions after five years of service). It’s ALL ABOUT CONTROL of the populace, people, plain and simple.
Our country is now spending trillions on premium subsidies, essentially to line the pockets of the exchange carriers and to create extra state bureaucracies and beef up county bureaucracies. The (PPO) exchange carriers’ reimbursements to providers have actually decreased by more than 100% since the inception of the ACA, causing many GREAT longtime providers who are in a position to retire to voluntarily give up their practices.
If a candidate such as Trump has an agenda to decimate the ACA and start over, I’ll volunteer my services to that end. I now have enough “ammunition” which will prove to be so utterly ridiculous to “John Q Public registered voter” that it will make CC and CA County SS agencies look like the flaming “make-work” idiots that they are. I’m getting very close to filling out that new voter registration form I have bookmarked, and, depending upon the outcome of the CA primary election, drafting letters (with [redacted] exhibits) …. to be mailed (certified) to the “appropriate entities” just in time for the “general election campaign season.” If I’m ever needed out of town to testify to the PTB or a campaign rally as to this travesty taking place every business day, all day at the hands of CA state gubment, I’ll be there with bells on :=0
