Affordable Care Act: Q&A
Subsidies to help people pay for insurance premiums are a key part of the Affordable Care Act. Here are some questions and answers about the subject.
Q: How can I find out if I might qualify for a subsidy?
A: Try out the calculator at www.wahbexchange.org/info-you/individuals-and-families/. These will be only estimates, as actual state plan rates have not yet been added.
Q: How large might the subsidies be?
A: According to the state, a family of four making up to $40,000 could qualify for up to an estimated $985 in subsidies per month. If the family makes up to $90,000, the subsidy could be as much as $436 per month.
Q: How will the subsidies be calculated?
A: The amount a person or family has to pay for a midlevel insurance plan is limited by income. For those making up to 133 percent of the federal poverty level ($15,856 for an individual and $32,499 for a family of four), the limit is 2 percent of income, while for those making 300 to 400 percent of the poverty level, the limit is 9.5 percent of income.
The plans are sorted by level, from “bronze” to “platinum,” with the lower-level bronze plans having smaller premiums but requiring higher levels of cost sharing. The subsidy is calculated using the second-highest, midlevel “silver” plan. If that plan costs more than the income-limited amount, the person or family would get the difference back in tax credits. If they pick a higher-level plan, though, they still would get the same tax credit.
Q: I’m young and don’t have a lot of money. What are my options?
A: By going to a “bronze” level plan, it’s likely a 32-year-old nonsmoker in King County could pay as little as $196 per month even if they don’t qualify for a subsidy, and less if they do, according to the office of the insurance commissioner. And those under 30 can still buy “catastrophic” limited-coverage plans with lower premiums.
Q: So what happens if I don’t buy insurance?
A: You’ll be assessed a penalty of $95 or 1 percent of your income, whichever is greater, on your income tax, with the amount rising sharply in future coming years. And potentially, advocates add, become a burden on your family and friends, face piles of bills and in extreme cases, bankruptcy.
— Carol M. Ostrom