<p>He can buy ACA insurance in PA. He just can’t get subsidized insurance. The $100/month is the unsubsidized price for a catastrophic policy in one part of Pennsylvania. The price will vary in different parts of the state, and will be higher for more coverage.</p>
<p>@Cardinal Fang</p>
<p>Hey CF, what are you a seeing that I am not understanding? It appears from the article from Kaiser that I linked that since he has income under $116000 that they do not believe he can afford any insurance. Therefore do not allow him to purchase ACA insurance. If he was able it would show in the chart.</p>
<p>What am I missing? I</p>
<p>Found it.
<a href=“I have no income and don't qualify for Medicaid in Pa. or financial support for the exchanges. What now?”>I have no income and don't qualify for Medicaid in Pa. or financial support for the exchanges. What now?;
<p>@Beil1958 </p>
<p>Can buy a catastrophic plan. This looks like a good bet for 4 months and then can be enrolled ACA for next year as Pa. is expanding in some form.</p>
<p>@sax Ignoring the roll out issues at healthcare.gov, I have found it to be a helpful source of information for specific ACA health insurance questions. Where I work, we call this a “your money or your life” issue. We are always told to get and give advice from a primary, authoritative source.</p>
<p>To echo others, he will be eligible for Medicaid in PA soon-ish. </p>
<p>Obviously, Medicaid differs by state, but I’ve had nothing but great experiences with Medicaid. Especially for a young, healthy adult, it’s a great safety net. </p>
<p>You can buy ACA health insurance even if you are under. I know a number of folks here who are doing it. You just iinput the income requred. We did that for my one son rather than have hm on MEdicaid, though I do believe he is now eligible legitimately, and Medicaid has been enhanced by ACA and improving. The problem with Medicaid is that a lot of health care providers flat out won’t take it. The ACA expansion of it is helping in that respect but is still not there.</p>
<p>My D is a recent graduate. We (the parents) live overseas, so we have no US insurance policy. She currently has one part-time job in her field and is looking for a 2nd one. When she applied for ACA insurance, she had to show proof of income. When she sent it in, they said that she was “too low” for a subsidy and instead qualified for Medicaid. Since she didn’t want Medicaid, she had to send a letter explaining her circumstances and her “anticipated” annual income. She got the subsidy and has a very nice policy (silver level) for $50/month and a waiver of the deductible. Obviously, they will “adjust” her subsidy come tax time, but I really can’t foresee her getting a high paying job by the end of the year. </p>
<p>Everyone can decide what they are willing to do to avoid paying for their own/their adult child’s insurance if the adult child has no income. Note, however, that doing as cptofthehouse recommends, stating that your income is greater than $11K when you know it is considerably less, in order to qualify for subsidies, is fraud.</p>
<p><a href=“http://lecom.edu/financial-aid.php/School-of-Dental-Medicine-Tuition-Fees/49/2205/621/2486”>http://lecom.edu/financial-aid.php/School-of-Dental-Medicine-Tuition-Fees/49/2205/621/2486</a></p>
<p>You should check with the graduate school before buying a policy, because they might require you to pay for their health insurance.</p>
<p>For example LECOM states on their tuition and fees page that health insurance is mandatory for some of their professional schools, for example School of Dental Medicine, Medicine and Pharmacy.</p>
<p>@cardinalfang, It seems to me that it is a 6 in one, 1/2 dozen in the other situation. If you have no income you get Medicaid, which is no cost to you. If you have a small income, you use the marketplace and get a subsidy and pay a small premium. It seems that cpt added income to get greater Dr. choice, .not to pay less for care.</p>
<p>Definitely a complicated situation.</p>
<p>Agree with above. Check with your school. At D’s school, full time graduate students are required to buy offered insurance unless they can prove they have a certain amount of coverage from somewhere else. We still cover D so we got a waiver. I would think in many cases it would be easier to use college’s insurance than go through hassle of ACA or qualifying for Medicaid. Of course that means extra cost that student has to cover. I my child was too old to be covered under our policy, this is an expense I would help with.</p>
<p>Getting subsidies by stating that your income is > $11.6K when your income is actually near zero is fraud, and it is illegal. You may think that disobeying this particular law is justified. You may think you won’t get caught, and you probably won’t. I’m just saying if you do this, you are violating the law.</p>
<p>Don’t most schools require a policy that meets some minimum criteria? How can it be okay to attend a school with a price tag in the tens of thousands while claiming poverty for taxpayer-funded medical benefits. This makes no sense. </p>
<p>In the main ACA thread, it was suggested that people can overestimate their income to avoid the donut hole of making too much for Medicaid and too little for subsidies in the non Medicaid expansion states. And then the payback that would be required at tax time would be limited because of the “clawback” provision. For people who don’t want Medicaid but who do want subsidies, they could overestimate their income, also. Maybe the subsidies should be contingent upon previous year’s income instead of estimation of what the current year’s income will be (like FAFSA). </p>
<p>I don’t think it’s right to deliberately lie, but others on that other thread disagreed. It was stated that what’s wrong with being optimistic that one would make more money in the coming year?</p>
<p>I guess just about anything can be justified by some people.</p>
<p>I do think that for twentysomethings, especially, income is not easily predicted, the same for many self employed people (like a realtor), so an estimate could be optimistic or pessimistic and still be realistic. Joe does not know if he is going to make that extra $6000 until he does or does not sell that $200,000 house, or junior does not know how much his job will be in the summer when he graduates, maybe he gets a great six figure income, maybe he is unemployed or underemployed? He could theoretically get Medicaid January- June, then make $50k the rest of the year.
So, yes, an out and out lie is not good, but a self-serving estimate is justifiable, I think.</p>
<p>Maybe basing a poverty program on estimates is not a great public policy. But sure, people will figure out a way to benefit and who really can blame them? Medicaid in most states is only a good deal until you want a doctors appointment. At that point, good luck. </p>
<p>Part of the ACA was raising the Medicaid reimbursement rates to approximate Medicare’s reimbursement rates for PCPs. In the Medicaid expansion states, has that been happening? There should be a big increase in doctors taking Medicaid in those states, if reimbursement rates have gone up. Has that been happening? Or are many of the new Medicaid recipients left with very few doctors that will take Medicaid?</p>
<p>Catastrophic policy won’t meet the parameters required by his school…School offers a policy but he thought it was expensive. When you’re used to free, paying–regardless of the amount–IS expensive! His debt is going to be huge, so what’s a few more bucks!<br>
I haven’t focused on the topic since my employer offers outstanding coverage at a relatively small premium. Very lucky for us!</p>
<p>Re: Income and ACA</p>
<p>I would think that when taxes are due and you have to fill out the form (1095-A) that they require the IRS will get an immediate red flag that you did not have income therefore will penalize you. </p>
<p>Well, how do they penalize you if you have no income?</p>