Monday, September 30, 2013

Your Five-Step Guide to Obamacare Week

While the Republican House GOP clown show continues, the rollout of the Affordable Care Act, frequently called "Obamacare" will press on, at least in those states that have state-based exchanges.

The basic structure of the Affordable Care Act is fairly simple. To understand how Obamacare will affect you, you need to know the answers to five questions:
  • Are you insured by the government today? If so, then nothing will change. You can stop reading this post and do something more interesting with your life.
  • Does your employer provide insurance? If so, you need to know the answer to a follow-up question: is your employer's insurance good insurance? If it's decent insurance -- no annual or lifetime caps on coverage; reasonable co-pays, deductibles, and coinsurance -- then nothing changes.

    If your employer only offers crappy insurance, they will  need to start providing real insurance. If they don't, you'll go buy your own policy on the exchange. Most employees -- about nine out of every ten -- get decent insurance through their employer. Only one in ten employees will need to lobby their HR department for better insurance coverage.
  • How much does your family earn?

    The handful of middle-to-high income earners -- those making more than 400% of the Federal Poverty Line --  that don't have employer-sponsored insurance will need to go buy it at full price. Thankfully there are not many households like this -- good-paying jobs tend to have good benefits -- and these folks will mostly be able to afford their insurance without too much of a pinch.

    Working-class and middle-income households -- those between 133% and 400% of FPL -- make up the largest group of the uninsured. They'll get some subsidies to purchase insurance at a discount. There are lots of online calculators. My two favorites are Kaiser's Affordable Care Act premium calculator and the state of Vermont's maximum monthly premium table.

    Where the States Stand
    Low-income households need to know the answer to one more question: is your state governed by troglodytes, or by human beings? States governed by human beings (colored teal or blue on this map) will expand Medicaid to cover anyone earning less than 133% of FPL. States governed by troglodytes (colored red or pink) will not cover anyone earning this little money. As a silver lining, subsidies will be available to those earning 100-133% of FPL. So the trick in these states is to be poor, but not too poor.

    Okay, I guess you need to know the answer to one more question. What is 400% of the poverty line? Or perhaps what is 133% of the poverty line? According to Medicaid.gov, here are the income thresholds for 133% and 400% of FPL:

    Single person: 133% of FPL = $15,281.70 ($1273.48/month); 400% = $45,960 ($3830/month)
    Family of 3: 133% of FPL = $25,974.90 ($2164.58/month); 400% = $77,410 ($6510/month)
    Family of 4: 133% of FPL = $31,321.50 ($2610.13/month); 400% = $94,210 ($7850/month)
I put this together in a handy flowchart, showing what percentage of Americans are currently covered by the government, their employer, buy insurance on the individual market, or go uncovered. The percentages here are approximate, but give you a rough idea of how many people will be helped by Obamacare (click for full-size version)



Good luck!

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