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I live in a state that is going for the Medicaid expansion.  This means 60% of my fellow employees now qualify for Medicaid but we can't get it because our job offers a much more expensive Health Insurance plan.  We also won't get a tax credit for the same reason.

But at the same time we get told that our health insurance is better than Medicaid and cost less which is why we won't get the tax credit unless we consider dropping the requirement in the contract to provide health insurance.

I asked my steward for clarification.

More after the squiggle.

The shift steward told me this was true.  We can't get the tax credit, unless we go and buy insurance from the exchange and then attest that we don't have an offer of health insurance from our employer.  But we should go to the exchanges and see that some of the lower cost plans would work better for us depending on our families needs.

She also told us that we would not qualify for Medicaid because we have jobs.  So I question the information she is giving out.

She did explain that it was something the union was looking at for next years contract negations to let the County drop insurance so employees could get medicaid or tax credits.  They are not set on that, but are looking into it. (I guess fighting for better pay so that 60% of the EMS providers don't qualify for Medicaid is too much to ask.)

At the same time we were told that because of ACA, starting next year we could expect to see our run volume increase as more people would be covered by insurance and would call 911 more.  They point to a change in the Medicaid rules about four years ago that allowed single people with no kids to get on Medicaid and the increase in 911 calls after that went into effect.

My thinking is that with more people having insurance would mean that the 30% who currently don't pay because they are uninsured should change and the County will be bringing in more funds as Medicaid/health exchanges starts paying. (even better argument to increase wages, you are binging in more money for your service)

What they are saying is that ACA won't save money because more people will be calling 911 to go to the emergency room.  The idea behind ACA was, to my understanding, that with insurance they would be able to get treatment BEFORE they needed to go to the ED.  If anything we should see less calls, higher repayments of bills, and better pay.

It bothers me that the union and management are saying historically 911 usage will go up as more people have insurance.  It bothers me that the union would even consider dropping our insurance as a way to 'save' us money.  It bothers me that i'm told that because I have access to a plan that costs $480 every two weeks [edit: each month paid every two weeks], but my pay is such that with out any overtime I qualify for the Medicaid expansion (which is free), I can't take the cheeper option AND I can't get the tax credit to cover what i'm paying now.

Is there any links to how I and my fellow workers can get the tax credit with out having to gut our contract?

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