Saturday, June 30, 2012

I Will Be Eligible for Medicaid (But the Devil's in the Details): Obamacare: An Act of Human Decency that Is also Fiscally Responsible

There's great coverage of all the points on the two Op-Ed pages of the Friday, June 29, 2012, NYT. 

If you've thought that obtaining health care was tatamount to taking 60+  $100 bills and running out into the street and letting the wind carry them away, and if you're self employed and have all those tax deductions like self employed people do, then if your Adjusted Gross Income (AGI) on your tax forms is within 138% of the Federal Poverty level, then YOU WILL BE ELIGIBLE for Medicaid IN 2014.

How do we get to 138% of the Federal Poverty Level?

".....The ACA expands Medicaid to a national floor of 138% of poverty ($15,415 for an individual; $26,344 for a family of three). The threshold is 133% FPL, but 5% of an individual’s income is disregarded, effectively raising the limit to 138% FPL. The expansion of coverage will make many low-income adults newly eligible for Medicaid and reduce the current variation in eligibility levels across states. To preserve the current base of coverage, states must also maintain minimum eligibility levels in place as of March 2010, when the law was signed. This requirement remains in effect until 2014 for adults and 2019 for children. Under the ACA, states also have the option to expand coverage early to low-income adults prior to 2014. To date, eight states (CA, CT, CO, DC, MN, MO, NJ and WA) have taken up this option to extend Medicaid to adults. Nearly all of these states previously provided solely state- or county-funded coverage to some low-income adults. By moving these adults to Medicaid and obtaining federal financing, these states were able to maintain and, in some cases, expand coverage. Together these early expansions covered over half a million adults as of April 2012...."

Here is a snapspot of what is taking place currently, in 2012, across the 50 States, aggregated data:

8326_Figure 1

Here is a great site for all the bits and pieces of information:

Right now, for NC, you must be within 49% of Federal Poverty Level (looks like I need to re-do my Federal Income Taxes perhaps).  However, as associated with the matter of 'the devil's in the details', does NC have a category for me delineated as: "Working Parents"? Dunno.  And what is the age of the person to be considered 'Elderly'?

According to the Feds, age 60 or older is 'Elderly':

"Who is Elderly?A person is elderly if he or she is 60 years of age or older."

In looking at NC Medicaid charts, there appears to be no categories for "Working Parents":

Here info for current yea re: all the various statesr:

Here is info re: Federal Poverty Level:

These are some of the more salient points across the editorials:


".....How many people are we talking about? You might say 30 million, the number of additional people the Congressional Budget Office says will have health insurance thanks to Obamacare. But that vastly understates the true number of winners because millions of other Americans — including many who oppose the act — would have been at risk of being one of those 30 million...."


"......And here’s the biggest gift that Roberts gave to the nation: By restraining the power of the court to shape health care policy, he opened up space for the rest of us to shape that policy through the political process. By modestly refraining from rewriting health care laws himself, he has given voters and politicians more room to be audacious....."

3.  THIS is the Editor(s) of the NYT outlining the entire matter and its a worthwhile organizing the more subtle points:

".....THE PRACTICAL IMPACT In general, the decision means that tens of millions more Americans will have access to affordable health insurance and that reforms in how medical care is delivered and paid for can be aggressively pursued to bring down the cost of health care. Most of the changes will take effect in 2014, like coverage for adults with pre-existing conditions. Many popular provisions are already in effect, including mandated coverage of pre-existing conditions in children and allowing parents to keep their children on their coverage until they are 26.

The law covers preventive care without cost-sharing by Medicare patients and improves preventive care coverage in private plans. It bans insurers from imposing lifetime limits on how much they will pay for an individual’s care. The law is already providing grants to carry out demonstrations and pilot projects to encourage hospitals, physicians and insurers to coordinate care, eliminate waste and reduce medical errors. These initiatives will now be accelerated in coming years.
The major exception to the strong legal endorsement of the law involves Medicaid. The law called for states to expand their Medicaid coverage to virtually everyone earning up to 133 percent of the federal poverty level, or up to $25,390 for a family of three. It encouraged states to expand their programs by having Washington pay 100 percent of the cost of newly eligible enrollees for three years, with the subsidy decreasing after that to 90 percent. But it also contained an implied threat to withdraw all federal financing for Medicaid if a state refused to expand. By a 7-to-2 vote, the court said that was too coercive and upheld only the provision of additional funds.

We disagreed with the court’s legal reasoning on this point and believe that without the possibility of withdrawing federal funds, the reform law may fall short of ensuring near-universal coverage....."


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