Today I spent about 5 hours enrolling a friend for healthcare through the ACA.
She is on a limited income of $1321/month (Social Security) and just received notice from her private health insurance that her monthly premium is going up to $1100/month. She has many health problems so she has been "stuck" with her current insurance company because of pre-existing health problems. Anyway, we are in Missouri, which means we used the federal website to sign-up. Got through the verification and application process with no problems; go to the page to see what her subsidies will be and no tax benefits show up on the page, only says that she is eligible for ACA, but does not list any subsidies? One of the navigators thought it might be that she falls into the Medicaid gap hole, since our wonderful Republican Missouri legislature turned down the Medicaid expansion, even though our Democratic governor was for it. However, from what I understand, ACA subsidies are available for those who fall between 100% - 400% of the federal poverty level. The 100% level is a little over $11,000/year, and she is making right under $16,000. The other senior navigators we brought this problem to were puzzled also, for she clearly falls in the range for tax help for her premiums and deductibles.
Help please! Any ideas on what could have gone wrong? Has anyone run into this problem? We are planning on filing an appeal on Monday, Dec 9th, but of course she is very anxious with the 23rd Dec deadline looming.
I know she wanted to try to get on earlier, but she has been hearing so much negative things, until very recently, that she was scared of trying the system. So now she is in a bind.
The state of Missouri has made it so difficult for the federal navigators to help people also; they were not satisfied with the federal training they received, so they had to also be trained by the state before they could start helping people, which of course was simply delay tactics. The navigators are also forbidden to help the person in deciding on a plan. if you have never had to negotiate through insurance policies it can be absolutely overwhelming for the first time. It is just unbelievable the extent the opposition has gone to to try and make the ACA fail by making it as daunting as possible. I am really dumbfounded that people will go so far to hurt their fellow citizens who really need health insurance. It is so sad and disheartening.
Anyway, if there is anyone who really needs the ACA, it is my friend, and she certainly should qualify for lots of subsidy help. She currently suffers from cancer, RA, and lupus. We may also try to see if she can qualify for Social Security Disability; she has been turned down at least once, but from what I understand for SS Disability to take you seriously you have to first hire a lawyer, which I do not think she did when she first applied.
Any positive suggestions would be welcomed.