Sal Slacker is 30 years old. He doesn’t work. He lives in his parents basement eating fruit loops and playing video games all day. His parents don’t seem to have a problem with this.
So…? Does Sal get free health care? He doesn’t have a job (nor does he want one) so he doesn’t get employer provided health insurance, and he has 0 income so he can’t buy it on his own. He is over 26, so he doesn’t qualify to be on his parents plan.
What does the health care law say about losers like Sal?
Question 2:
Lucky Larry won the lottery 5 years ago. He took the lump sum payout of $100 million. He keeps all this under his mattress (no banks, no interest income). He of course quit his job. Today, while rich, Larry has no current income. No job means no employer provided health insurance.
Does Larry get free health insurance? He has no taxable income for which to pay for it.
In This thread Chimera posted:
Sal Slacker is going to need to get a job or get his parents to pay for his health care.
But gave no cite to the actual law to back this up. I’m asking a factual question here about what the law actually says. If Sal has to get a job or get someone else to pay for it, why wouldn’t homeless people have to do the same?
This is entirely irrelevant to the questions in the OP. Please refrain from stating your personal opinions on health care. We are only interested factual answers regarding what the US health care law says about the cases in the OP.
This goes for everyone. Partisan sniping on this issue is also not needed here.
I may be wrong, but it seems to me Sal Slacker is entitled to Medicaid, due to his lack of income and available money. So he is likely covered under those provisions.
Lucky Larry, of course, wouldn’t be so entitled.
I’m probably wrong, though. But it seems to me that one of the big issues about the fight over the ACA and the Supreme Court decision is that states were expected to increase their eligibility parameters for Medicaid, thus covering a large number of otherwise uncovered people who wouldn’t easily be able to afford health care insurance. The Supreme Court, in upholding the law, removed the requiremen for states to do this, and a number of states have made it clear they will in no way increase the number of people they will add to their Medicaid rolls. So it seems to me it isn’t Sal Slacker that’s the problem, but Always-lagging Amy, who earns a small income, just enough to put her out of reach of Medicaid, but not enough to actually afford health care insurance.
I’m not sure either case really has that much to do with Obamacare. Medicaid is the main method of covering people with zero income now, and will remain so under Obamacare. Obamacare primarily extends Medicaid coverage to part of the working poor, and covers the rest with a system of subsidies based on their income.
Most (all?) states have assets testing for medicaid. Some stuff is exempt (housing, primary transportion, etc) but I doubt 100 million dollars in cash would fall under those. So Larry would have to pay his insurance.
I think Sal would qualify for Medicaid. I guess technically he should report his free room-and-board as income, and thus might not, but practically I don’t think many people that live with relations do that.
He’s supposed to report his assets when he applies for Medicaid. Of course, he could lie, and HHS might not catch him in the lie, but then that’s true of anything. He could lie about his income to the IRS to avoid taxes, lie about his health to get cheaper life insurance, lie about his birthday to get a free sundae at the local restaurant.
I read your question as asking what the rules were for Medicaid. If your question is “is it possible to break those rules”, then the answer will be yes. But that’s true for almost any system.
Employers are mandated to provided health insurance or pay a fine. Does this pertain to all employees or just full timers? If it’s all employees who pays for a person that has 2 part-time jobs?
Question 4:
Employers who don’t supply health insurance get a fine. The fine is less than the insurance premiums. What is to stop an employer from cutting health insurance and just paying the fine? If large amounts of employers do this, forcing employees who can’t afford the insurance to go on the government plan, would this not overload the system?
You are wrong. Medicaid is typically not available to childless adults. However, there are exceptions in some states- but most of those require some type of premium contribution by the adult. Additionally, many states currently (or at least until the last several years) had asset tests they used, meaning that even if you had no income, if you have assets above a certain value, you still would not qualify for Medicaid or other programs. Under the ACA, that will change, and the asset tests are largely removed.
Assuming that both examples are childless adults, the ACA will expand coverage that would not have previously been available (again, minus the exceptions in a few states). However, while they could technically qualify for premium support under the ACA, it would be very difficult for someone in either of these circumstances to obtain any type of social welfare because of the difficulty they would have in documenting how they pay for their daily expenses.
It was supposed to make anybody eligible for Medicaid on the basis of income alone, but the Supreme Court ruled that states don’t have to implement that portion.
Fines will be based on full time (>30 hrs/week) employees and a calculation of full time equivalents (total monthly part time hours / 120). The situation for a person with two part time jobs remains the same - except it will be easier for them to purchase insurance if they insist on being responsible for themselves.
As an employer, I will be competing for employees. Unless all employers drop healthcare, I must compete against those who offer it. That will weigh heavily on any decision to drop coverage.
If I already offer coverage, I could drop coverage now if I wanted to do so and face no fine at all. Why would I choose to do so when I will be fined?
I don’t expect a large number of employers will want to anger their employees by dropping coverage or compete for the least qualified employee by offering the least benefits.
Neither hypothetical ne’er-do-well qualifies for Medicaid today, as they are non-disabled childless adults. A handful of states do cover childless adults through a federal waiver. But “canonical Medicaid,” so to speak, excludes this category, regardless of income level.
“Canonical PPACA” (the version that applies if states do not opt-out)* would expand eligibility to non-disabled childless adults up to 133% of poverty. Income would be evaluated under what is called MAGI (modified adjusted gross income). MAGI will replace current income-eligibility rules, and is meant to make uniform Medicaid eligibility requirements across the several states and promote administrative convenience (since this data is already reported to the IRS, thus relieving states from additional income-related data gathering).
Accordingly, under “canonical PPACA,” both hypothetical individuals could be newly eligible for Medicaid.
(Id. at 6, emphasis added, internal citation omitted.)
Or in short, “any income fully excluded from MAGI, such as gifts or inheritances, is not reflected in the examples, as an individual (or couple) could have an unlimited amount of these types of income with no impact on eligibility for the Medicaid expansion or premium credits.” (Id. at 9.)
Again:
(Id. at 14.)
Finally, the report notes that the wisdom of making a tax-based definition of income do double duty as a definition for public assistance eligibility may be fairly questioned. (Id. at 16-17.) Public assistance has, hitherto, looked both to income and liquid assets in determining eligibility. Moreover, it has been quicker to deem income and assets belonging to fellow household members to the public assistance applicant. Neither of these considerations is relevant in the taxation scenario; but are vital bulwarks against manufactured eligibility for public assistance.
Of course, this does not necessarily lead to where pkbites hopes it does. We need only eliminate the MAGI definition from PPACA’s eligibility regime and substitute are more appropriate definition (as we have for, say, SSI).
Recall, the Supreme Court rejected PPACA’s mandate to expand Medicaid eligibility and held that states may opt-out of this provision.
Irrelevant as to why. What happens if large numbers of employers do this?
What happens if Sal is not their son, but the bum that hung out with his sign on the freeway exit ramp. They let him sleep in their guest room and feed him, but are of no blood relation to him. He has no children and no source of income. Does Obamacare cover him for free?
Question 5:
A naturalist. Has no job. Never, ever paid income tax. Only asset is their tent they live in in the forest. They eat what they find in the woods, bathe in the streams of mother nature. But when a snipe mauls them they get infected with advanced mopery and need long term medical care. Covered for free?
Don’t you think that the fact that it won’t happen is relevant?
Companies can drop insurance now and not pay a penalty. Why would they be more likely to drop insurance when there is a penalty for it?
I would imagine, if companies stupidly and self-destructively stopped providing insurance, those workers could purchase insurance on the public exchanges.
Then people buy their own insurance. Or they find new jobs with competitive benefits packages. Same as today.
If they buy on the exchange, then the public exchanges get lots of young, healthy able bodied employed adults paying more into the system than they use in claims, and the fines the employers pay also (I think) go to fund the exchanges. In other words, it makes the exchanges work better.
I believe that the key factor is Household, as opposed to Family Income.
No change from current situation, Long Term Care is not a part of the ACA. However, since that may be too literal an interpretation of your use of ‘long term medical care’, they will be covered under the rules explained by Kimmy Gibler. Which means covered now under Medicaid, covered in future too.