A list of those hardships, reported by the Wall Street Journal, includes more than a dozen ways that Americans could qualify, including homelessness, having utilities shut off, and having a very low income in a state that did not expand its Medicaid program. Sebelius also refused to say whether the White House goal of signing up 7 million people will be met by the March 31 deadline, when open enrollment ends. Thus, the deadline for open enrollment will not be extended, according to Sebelius, despite lack of any clear data on the number of people who have both signed up and actually paid their premium. Individuals without coverage by the deadline will face a penalty at tax time, which will likely be deducted from any anticipated tax refund next year. Any way you look at it, the hope of the White House that individuals will actually buy into the private purchase of health plans seems largely misplaced. A great deal of the problem lies in the confusing array of plans that can be purchased through the exchanges. First, a purchaser must figure out what is being offered. Often termed “metal” plans: bronze, silver, gold and platinum, one would seemingly need to possess an advanced college degree simply to understand the choices. The lower-premium plans, are the “bronze" plans, which carry higher initial copayment responsibilities. This may at first seem attractive to a lower wage earner. However, such a plan would actually benefit a higher-income individual, who could afford the 40 percent copayment. The platinum plan, which costs more in premiums but carries a 10 percent initial copayment, would seem to be better suited to a person who lacks resources to pay nearly half of his initial healthcare expense from his own savings. Recognizing the problem faced by lower wage earners, there are three alternative silver plans for lower income earners, which the website Obamacare 411 explains as follows: “These three alternative health insurance plan options are only available for people that have the lower incomes. The three health insurance plans have lower out-of-pocket expenses for people that are enrolled in the health insurance plan. Basically, what this all means is that even though you are buying a silver tier plan; you are actually being given a better health insurance plan.
- 100 percent to150 percent of the federal poverty level (FPL) = 94 percent AV, better than average platinum plan
- 150 percent to 200 percent of FPL = 87 percent AV, better than average gold plan
- 200 percent to 250 percent of FPL = 73 percent AV, better than average silver plan
Article By Martin Merritt from Physicians Practice http://www.physicianspractice.com/blog/health-insurance-exchange-confusion-hinders-patient-sign-ups?GUID=2E8F906E-CDE7-43B7-AC93-7066F83372C7&rememberme=1&ts=18032014