Nearly 15,000 in Augusta will qualify for insurance subsidy, group says

Decision on Medicaid to affect who qualifies

 

More than 800,000 people in Georgia, including nearly 15,000 in Augusta, will qualify for subsidies to buy insurance under the new health care reform law, an advocacy group estimated.

Because Georgia is refusing an offer to expand Medicaid, though, many of those people will buy their own insurance instead, which would greatly expand those numbers, the group said. Without that expansion, however, many adults and poor working parents would be without any coverage because they would not qualify for help.

Families USA released its report Wednesday on its estimates of who would qualify for tax credits in Georgia and South Carolina under the Affordable Care Act. Enrollment in those plans begins in October and takes effect Jan.1.

Tax credits to help the uninsured purchase health insurance will be available for people who earn up to 400 percent of the federal poverty level, or about $46,000 a year for an individual and $94,200 for a family of four, said Ron Pollack, the executive director of Families USA. The majority of the subsidies – 54 percent – will go to people earning twice to four times the federal poverty level.

Those credits will be “reaching very deeply into the middle class” Pollack said. In Augusta, 52.7 percent of tax credit subsidies will go to people earning between two to four times the poverty rate.

The tax credit subsidies will also be largely going to working families – 88.5 percent of the credits will go to families where at least one person is employed.

Many workers in Georgia lack access to health insurance through their jobs and are among the 1.9 million – about 1 in 5 – who are uninsured in the state, said Cindy Zeldin, the executive director of Georgians for a Healthy Future. Others are buying health insurance on their own now but are getting expensive policies with gaps in coverage and bewildering restrictions, she said.

The tax credit subsidies are “that game-changer for people who have really struggled with a stressful and confusing market in the past,” Zeldin said.

The report’s analysis, however, assumed that both states would participate in expanded Medicaid coverage that would cover people earning up to 138 percent of the poverty level, which neither state’s governor appears willing to do. That would mean that people earning between 100 percent and 138 percent of the poverty level, between $23,850 and $32,499 for a family of four per year, could choose to take the subsidies and purchase insurance through the state marketplaces, Pollack said.

“If Georgia and South Carolina continue to stay out of the Medicaid expansion, these numbers are likely to go up,” he said. Cover Georgia, a group pushing for the Medicaid expansion, estimates that it could cover 600,000 currently uninsured residents.

The federal health reform law, though, does not allow subsidies below the federal poverty level, where it was assumed Medicaid expansion would cover them before the U.S. Supreme Court decision last year made that voluntary for each state. Medicaid in Georgia right now does not cover childless adults and covers only parents below 50 percent of the poverty level, Zeldin said.

“For those people below poverty, if the governors don’t opt into the Medicaid expansion, they’re out in the cold,” Pollack said. “They’re not going to be able to get tax credit premium subsidies. They’re just going to be uninsured. And it is extraordinary that the poorest of the poor, the people who need coverage and care the most are the ones who are going to be most left out in the cold.”

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DATABASE: New Health Insurance Estimates

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