As October rolls nearer, so does the beginning of your state’s health insurance marketplace. This marketplace is the spot for you to buy affordable insurance, and find out if you qualify for subsidies. Do you have all the information you need to make the best choice for your family?
Keep your questions coming! This month, we’ll focus on the subsidies available after Jan. 1, 2014, that will help make insurance affordable for many rural Americans.
I know my income determines whether I receive subsidies for health insurance. Is that my income before or after taxes?
The health insurance marketplace will look at your household modified adjusted gross income (MAGI) when determining whether you qualify for subsidies. Household income includes the incomes of the primary taxpayer(s) and their tax dependents (e.g., children). For most taxpayers, MAGI will be the same as Adjusted Gross Income (AGI). Here’s where you can easily find the AGI, depending upon the tax form you use: Form 1040 EZ – Line 4; Form 1040A – Line 22; Form 1040 – Line 38.
Between my spouse and me, our household income is about $30,000 per year. Our kids are grown. Do we qualify for a subsidy? If so, how much?
Yes! Because you are just under 200% of poverty, you qualify for a subsidy. You will likely pay a bit less than 6.3% of your modified adjusted gross income for health insurance. Check here to get a general idea of your own subsidy.
My daughter lives in North Carolina, works two part-time jobs and makes 80% of poverty. Will she get a subsidy?
Unfortunately, your daughter may be in a sticky situation.
The Affordable Care Act (ACA) was written to expand Medicaid to everyone below 133% of the federal poverty level. It gave subsidies only to folks above 100% of poverty. When the Supreme Court ruled last June on the ACA, they gave states the choice of doing this expansion or not. Right now, North Carolina has decided not to expand Medicaid. So if she doesn’t qualify for Medicaid now, she will not qualify in 2014 unless her income changes or she has a child. But your daughter also won’t have access to federal subsidies because she is under the poverty line.
The only silver lining is that she can apply for a “hardship waiver,” which will exempt her from the requirement to have insurance and thus not be penalized. Of course, that won’t help her if she gets sick – she still won’t have insurance.
These articles are meant solely to answer questions we receive and provide general information about the Patient Protection and Affordable Care Act. The Center for Rural Affairs does not offer or provide legal advice. CFRA is not an insurance agency, broker, or consultant; does not recommend any health insurance product or policy or provide any advice on the purchasing of health insurance; and does not accept any compensation or consideration from an insurance company, insurance broker, or insurance consultant. Read more about Healthcare and You: A Few Questions Answered