<p>So how would you know, for sure? Calling customer service does not always make things crystal clear. </p>
<p>I have also read that SHOP subsidies disappear in two years.
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<p>I am looking for advice for my friend.</p>
<p>She is a US citizen (over 26), but her parents are green card holders. They both work, but due to lack of good English skills, they work in low paid jobs and from what I understand not even full time.</p>
<p>She used MNsure (our state exchange) to apply for health insurance for her parents, but they got denied. She did not understand why, so she tried to call help line, but was on hold for 1.5 hours and then gave up. She works full time (which ends up being around 50-60 hours a week), so she cannot easily find time to call, only to be put on hold.</p>
<p>She told me that she is their sponsor and they are not eligible for any assistance, like food stamps and medicaid, etc. She thinks this is the reason they got denied. I am not sure what it means to be a sponsor if her parents already have green card. I repeatedly asked her if she was sure they had a green card and she told me yes.</p>
<p>She thinks that because they were eligible for subsidies (and probably for expanded medicaid) and are not US citizens, they were denied insurance altogether. We are in the state with expanded medicaid, so in theory even if their income is so low that they fall below subsidies threshold, they should still get medicaid. She told me she will pay for their insurance one way or another, but at this point she was not able to sign them up. </p>
<p>Can anyone shed the light?</p>
<p>How did she become a citizen? Did she marry someone?</p>
<p>A citizen can sponsor their parents to come to US on a greencard which is what I assume she did if she is saying she is a sponsor. But once they have a greencard, they do become eligible for assistance although she was the sponsor.</p>
<p>Lerkin, how long have the parents been in this country? </p>
<p>They would have to live in this country 5 years to be eligible to receive medicaid. I am not sure but they may not be eligible for any health care subsidies if they havent been in this country for 5 years. </p>
<p>I think there are a few exceptions for green card holders that are from certain countries. The parents should be able to buy insurance that is not subsidized.</p>
<p><a href=“http://www.tcdailyplanet.net/news/2011/08/31/minnesota-cuts-back-medical-care-immigrants[/url]”>http://www.tcdailyplanet.net/news/2011/08/31/minnesota-cuts-back-medical-care-immigrants</a></p>
<p>dstark - are you sure about a 5 year rule? In 5 years, a greencard holder can become a citizen anyway.</p>
<p>There are exceptions to the 5 year rule. </p>
<p>I thought I read that green card holders were not necessarily eligible for subsidies. One of these links contradicts that.</p>
<p>[A</a> Simple Guide To The Affordable Care Act For Immigrants | ThinkProgress](<a href=“http://thinkprogress.org/immigration/2013/10/01/2708441/affordable-care-act-immigrant-types-coverage/]A”>http://thinkprogress.org/immigration/2013/10/01/2708441/affordable-care-act-immigrant-types-coverage/)</p>
<p>[How</a> will immigrants fare under Obamacare? It’s complicated | Local News | The Seattle Times](<a href=“http://seattletimes.com/html/localnews/2021756180_immigranthealthxml.html]How”>http://seattletimes.com/html/localnews/2021756180_immigranthealthxml.html)</p>
<p>not sure if this article is on point to your post, jerkin…</p>
<p>[Immigrants</a> qualify for Obamacare once they become permanent residents * - NY Daily News](<a href=“http://www.nydailynews.com/new-york/citizenship-now/green-card-holders-qualify-obamacare-article-1.1456825]Immigrants”>http://www.nydailynews.com/new-york/citizenship-now/green-card-holders-qualify-obamacare-article-1.1456825)</p>
<p><a href=“http://thinkprogress.org/immigration/2013/10/01/2708441/affordable-care-act-immigrant-types-coverage/[/url]”>http://thinkprogress.org/immigration/2013/10/01/2708441/affordable-care-act-immigrant-types-coverage/</a></p>
<p>Texaspg, here is the health cost information you asked for. Tom1944’s correspondent wrote “the costs for the top 10% of the sickliest in the US were $18,500 per year.” That vastly understates the case. Look at the chart on page 8.</p>
<p><a href=“http://kaiserfamilyfoundation.files.■■■■■■■■■■■■■/2013/01/7670-03.pdf[/url]”>http://kaiserfamilyfoundation.files.■■■■■■■■■■■■■/2013/01/7670-03.pdf</a></p>
<p>This is 2009 data, and costs have gone up since then, but the percentages will be the same. The sickest 10% of the population consume 62.5% of the health care costs. With a little arithmetic, we can compute that the sickest 10% averaged almost $50,000 a year in health care costs.</p>
<p>People 65 or over cost, on average, a whopping $9744 per person. On average. I’m too lazy to do the rest of the arithmetic, but if I did I’d probably find that Tom1944’s figure of $18,500 per person for the sickliest 10% refers to the sickliest 10% of people under 65.</p>
<p>
</p>
<p>I know she came to US legally, but I am not sure how. I think she won a green card. She’s been here long enough to become US citizen and then she sponsored her parents to come here. I know that she and her husband help her parents materially, because her parents are not able to find good jobs.</p>
<p>
</p>
<p>I am not sure, but I do think it was less than 5 years. We were discussing the problem she was facing at the party (yes, I know, very exciting topic of conversation) and somebody else mentioned the rule change, that not all green holders can qualify for welfare type benefits. So I think it is the subsidies that are the root of the problem.</p>
<p>I think she will have to price the insurance on the exchange (you can do so without signing up), choose the one she can afford to pay for her parents and then buy it directly from the insurance company.</p>
<p>lerkin, Assuming that your friend’s parents can’t qualify for health care subsidies, she doesn’t have to go to the exchange to shop for insurance. She can just shop at, for example, <a href=“http://www.ehealthinsurance.com/[/url]”>http://www.ehealthinsurance.com/</a> .</p>
<p>I don’t know whether legal residents who wouldn’t be eligible for subsidies are allowed to buy on the exchange. I would suspect they are, because why wouldn’t they be, but in any case, it would probably be easier for your friend to go to ehealthinsurance or some other similar site, or talk to an insurance agent.</p>
<p>CF: the Kaiser paper said that 1% had over $51,000 in medical costs.</p>
<p>What I could not find in that paper was what I see as the really salient information. That is “how many of the sickest 1% or 10% (who have the really high medical expenses) were Uninsured and were not eligible for Medicaid”.</p>
<p>TatinG, let me spell out the arithmetic here. </p>
<p>The average health cost per person was $7598. 10% of the people used 65.2% of the total cost. Ten percent is .1, 65.2% is .652. So the calculation is </p>
<p>7598 * .652 * (1/.1) = 49538.96</p>
<p>So the sickest ten percent of people used, on average, $49,539 per person in 2009.</p>
<p>The sickliest one percent had AT LEAST ~$50K in costs. But the sickliest ten percent had ON AVERAGE ~$50K in costs.</p>
<p>I don’t know the answer to how many of the sickest 10% of people under age 65 are uninsured and ineligible for Medicaid; I’ll look. It’s also worth considering the plight of some of sickest 10% who manage to cling to exceedingly expensive and/or bad insurance.</p>
<p>CF - your math skills are impressive! I had to put it in a spreadsheet to come up with that answer because I did not understand your equation!</p>
<p>15% of people were uninsured, at least for some period of time during 2010. I don’t know how many are illegals (pertinent because they are not covered by ACA). So the question is then how many of those 15% overlap with the sickest? How many are the so-called young, invincibles?</p>
<p>texaspg, I came up with the equation after the fact. The way I actually figured it out was more intuitive: 10% of the people have 65.2% of the costs. The costs are $7598 per person. Pretend there are 10 people in the US. Ten percent of 10 is 1, so one person will be very sick. Then the total costs are $75,980, and that one very sick person has 65.2% of the total, or $49,538.96.</p>
<p>Maybe that explanation is no better than the equation. If so, sorry. I like math, and I play around with statistics a lot, so I have some facility. But there are usually a lot of different ways to attack math problems, and spreadsheets work fine.</p>
<p>I went the linear way, multiplied with a hundred, derived 65%, and divided by 10 (same as you when it is condensed to 100/10 down to 1/.1). I guess you will be much faster than me at SAT math. :p</p>
<p>TatinG, a report on who is uninsured:</p>
<p>[Key</a> Facts about the Uninsured Population | The Henry J. Kaiser Family Foundation](<a href=“http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/]Key”>Key Facts about the Uninsured Population | KFF)</p>
<p>It doesn’t directly answer your question, but once again we can get a ballpark figure with some arithmetic:</p>
<p>
[quote]
Over 47 million nonelderly Americans were uninsured in 2012. <a href=“This%20includes%20American%20citizens,%20legal%20immigrants%20and%20undocumented%20immigrants.”>/quote</a></p>
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</p>
<p>The report says that people without insurance are, unsurprisingly, sicker on average than those with insurance: “Receiving needed care is especially important for the uninsured since they are generally not as healthy as those with private coverage.” But for a ballpark figure, let’s assume that people without insurance are on average just as healthy as others. </p>
<p>How many US citizens are uninsured? 47 * 80.3% = ~38. OK, about 38 million US citizens are uninsured. Of those, how many are in the sickest 10%? That’s easy: 3.8 million. So a good ballpark estimate for the number of people who have no insurance, are under 65, and have expensive health costs is 3.8 million. We might want to round that up a bit, because we know that uninsured people aren’t as healthy as insured people. So we can give 4 million as a round figure: we can estimate that ** 4 million US citizens are uninsured and have high health costs**.</p>
<p>The definition of uninsured is uninsured for some period of time during the year. People between jobs that have employer provided insurance would be counted as uninsured. </p>
<p>It would have been important to know these numbers, that is, uninsured and really sick,to know if it’s the fly-sledgehammer situation.</p>
<p>Are those on Medicaid counted as uninsured?</p>
<p>
</p>
<p>(page 8) Take a look at the graph. Only 13% of the uninsured are uninsured for less than 3 months. </p>
<p><a href=“http://kaiserfamilyfoundation.files.■■■■■■■■■■■■■/2013/10/7451-09-the-uninsured-a-primer-e28093-key-facts-about-health-insurance1.pdf[/url]”>http://kaiserfamilyfoundation.files.■■■■■■■■■■■■■/2013/10/7451-09-the-uninsured-a-primer-e28093-key-facts-about-health-insurance1.pdf</a></p>
<p>So the number w/o health insurance for a year and with high health costs is 3 million or roughly 1 percent of the population.</p>