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View Diary: Falling Through the Cracks: My Healthcare Marketplace Story (35 comments)

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  •  Michigan waiting for federal waiver; April 2014? (0+ / 0-)

    Michigan has applied for a federal waiver that would allow it to expand Medicaid with some "cost-sharing" provisions that are not part of the standard Medicaid program. Michigan needs a waiver from the federal government in order to be allowed to do this. Best I can tell from Google, the waiver application is still pending.

    And apparently Michigan wants the expansion to be effective April 1, 2014, not January 1.

    If approved, Medicaid in Michigan will cover adults up to 133% of the federal poverty line. (Actually 138%, as the first 5% of income must be "disregarded" under federal law.)

    Details:

    [see footnote 3:] http://kff.org/...

    http://www.nejm.org/...

    http://www.crainsdetroit.com/...

    http://www.mlive.com/...

    December 2:

    Across Michigan, hundreds of thousands of residents who may be eligible for the state’s Medicaid expansion remain in frustrating, bureaucratic limbo — one that could push arguably affordable coverage out of their reach if they don’t get answers soon.

    Those residents won’t know for sure until next year whether they’re eligible for an expanded Medicaid under the health reform law. But for many, it could be too late to access tax credits now to make policies more affordable on the Michigan Health Insurance Marketplace, or state exchange.

    Bottom line: it's just too soon for the diarist to be able to know whether or not he/she will be covered. If the Medicaid waiver is granted, he/she should be covered.

    If the diarist is below poverty but not Medicaid-eligible, then the diarist will be exempt from the mandate (so no penalty):

    Individuals who cannot afford coverage because the cost of premiums exceed 8 percent of their household income or those whose household incomes are below the minimum threshold for filing a tax return are exempt. People experiencing certain hardships, including those who would have been eligible for Medicaid under the health law's new rules but whose states chose not to expand their programs, also are exempt.

    Other exempt groups include prisoners, Native Americans eligible for care through the Indian Health Service, immigrants who are in the country illegally, people whose religion objects to having insurance coverage, members of a health care sharing ministry and individuals who experience a short coverage gap of less than three consecutive months.

    If you are seeking an exemption for incarceration, membership in an Indian tribe or health care sharing ministry, you can apply through the health insurance exchanges or make a claim when you file taxes. If you are claiming economic hardship or a religious exemption, you must get an exemption certificate from the online insurance exchange. If you are claiming that coverage is unaffordable, that you are in the United States without proper documentation or that you have a coverage gap of less than three months, you can make the claim when you file your 2014 taxes in 2015.

    Americans who live abroad for at least 330 days within a 12-month period also are not subject to the mandate.

    "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

    by HeyMikey on Tue Dec 17, 2013 at 05:24:09 AM PST

    [ Parent ]

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