ObamaCare: What’s in Stock For The Taxpayer? (Part Two)
By: Dr. Peter Ikre
As we make plans toward the commencement of the second Open Enrollment Period (OEP) scheduled from November 15, 2014 to February 15, 2015, it is prudent to
revisit the outcome of the
recently concluded enrollment process that took place between October 1, 2013 and March 31, 2014. Although the first OEP of the Affordable Care Act (ACA) was inundated with problems, the enrollment figures turned out to be outstanding by any standard. According to the Department of Health and Human Services (2014), more than 8 million individuals selected a plan through the health insurance marketplace including those controlled by the federal government (Federally-Facilitated Marketplace or FFM) and the State-Based Marketplace or SBM. The Congressional Budget Office (CBO) had projected an enrollment figure of 7 million for 2014, which was later revised to 6 million to reflect averages over the calendar year. In another development, Rogers (2014) reminded readers that the original objective of the first OEP was to register 7 million people with 2.7 million of them being young and healthy enrollees between the ages of 18 and 34. So far, it appeared the administration met some of those expectations! A breakdown of the figures released by the Department of Health and Human Services (DHHS) indicated that 28% (2.2 million) of those who selected a Marketplace plan during the enrollment process were young adults between the ages of 18 and 34. Overall, a total of 2.7 million persons (34% of enrollees) aged 0 to 34 made a plan selection during the period. Aside from the government-controlled marketplace, it is important to state that an additional 5 million individuals purchased insurance coverage from other Affordable Care Act-compliant, off-marketplace plans. On the whole, the numbers were impressive. Nonetheless, some in the community have expressed fears concerning the direction of premiums in the year 2015 and beyond with respect to payments made by young enrollees in the program. Rogers (2014) stated that for the ACA to function as envisaged by the current administration, the system needs an ample number of young folks to offset the costs of insuring sick and poor individuals accessing the exchanges. These individuals cannot be charged more for healthcare if they cannot afford the bill. The alternative is to increase the premiums of others in the system. Moreover, earlier reports showed that only one-quarter (25%) of individuals between ages 18 and 34 had made the mandatory initial premium payment. Let’s hope the percentage changes before the end of the year. The quantity and quality of enrollees matter for sustainability of Obamacare.
It is true that the Open Enrollment Period for 2014 is over; nevertheless, the marketplace is still open to those experiencing certain events in their lives. These events may qualify them for the Special Enrollment Period (SEP), such as: a) a change in marital status (marriage, divorce), b) a change in dependents (birth, adoption, or undertaking placement of a child), c) moving permanently to a new location (state) with health plans diametrically opposite to one’s current choices, d) change in immigration status, for example, becoming a green card holder or citizen, e) experiencing a change in income, f) an enrollment error on behalf of the marketplace, g) losing minimum essential health coverage due to job loss, divorce, loss of Medicaid/CHIP eligibility, expiration of COBRA coverage, or decertification of a health plan, h) being already enrolled in a Marketplace plan, but experiencing a change in income or household status, affecting tax credit or cost-sharing reduction eligibility, i) ineligible to be on one’s parent’s healthcare plan at 26 years of age. In addition, one may qualify for SEP as a result of system errors related to immigration status, error displays on HealthCare.gov website, Medicaid/Marketplace transfers, unresolved caseworks, and victims of domestic abuse (Department of Health and Human Services, 2014). The SEP also applies to those eligible for Medicaid and the Children Health Insurance Program or CHIP. If any of the aforementioned criteria applies to you, please contact a Marketplace representative at 1-800-318-2596. You can also visit any of the numerous locations in town offering such services to the public including mine (Investigroup, Inc @ 1282 Liberty Avenue, Hillside, NJ. 07205. Tel: 9086884778). Remember, the initial penalty for failure to purchase health insurance (Individual Mandate as codified in the ACA for the year 2014) is $95 per individual up to $285 per family or 1% of taxable household income, whichever is greater (Manchikanti & Hirsch, 2012).
References
Department of Health and Human Services (2014a). Health insurance marketplace: Summary enrollment report for the initial annual open enrollment period (October 1, 2013 – March 31,
2014). ASPE Issue Brief. Retrieved from http://aspe.hhs.gov/health/reports/2014/marketplaceenrollment/apr2014/ib_2014apr_enrollment.pdf
Manchikanti, L., & Hirsch, J. A. (2012). Patient Protection and Affordable Care Act of 2010: A primer for Neurointerventionists. Journal of Neurointerventional Surgery, 4(2), 141-146. doi: 10.1136/neurintsurg-2011-010036
Rogers, K. (2014). New Obamacare numbers: 8M enrollees with 28% being young individuals.
FoxBusiness. Retrieved from http://www.foxnusiness.com/personal- fnance/2014/05/01/new-obamacare-numbers-8m-enrollees-with-28-being-young-
individuals/
Dr. Peter Ikre has more than 25 years experience in Healthcare, Accounting, Taxation, Business Management and Financial Consulting both locally and internationally. Dr. Ikre is currently a tax expert and loan modification specialist at Investigroup, Inc. You can reach him at 9083421160 (cell); 9083441806 (alt.); 9086884778 – office; email: pikre@investigroup.org
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