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Another Obamacare Surprise: Married Couples Not Eligible For Subsidies Given Single Filers

| December 5, 2013

Until Obamacare do them part. (MrT in DC)

Until Obamacare do them part. (MrT in DC)

As the Affordable Care Act wobbles into its second month, more people are enrolling on the healthcare.gov website and learning if they are eligible to get a subsidy and what their monthly premium payment could be.

Not everyone is happy, especially those who happen to be just above the subsidy cutoff.

Some single older adults who don’t qualify for a subsidy – the cutoff is $45,980 for one person – are pulling out dictionaries (it’s a book older people use) and rereading the definition of affordable.

In Southeastern Pennsylvania a silver-tier plan, which covers 70 percent of insurance costs, can carry a monthly premium of $575 to $1,012, depending on the plan.

For middle class married couples who don’t have children, the subsidy cutoff is $62,000. A silver-tier policy premium for two can range from $1,150 a month to $2,021, again depending on the plan.

Some of those couples are complaining that the law has a hidden marriage penalty. Here’s why: Say a couple has a household income of $70,000 with one spouse making $30,000 and the other $40,000. Combined, they are ineligible for a subsidy. But if they were just living together, each would be eligible for a subsidy.

“We’ve known all along that some people will do better in this market and some people will do worse,” said Joel Ario, a managing director at Manatt Health Care Solutions and a former Pennsylvania insurance commissioner. “In the long run everyone gets more stability out of the marketplace.”

The ACA, like the tax code, is complicated, and it sometimes provides a marriage subsidy and a penalty, said Mark Duggan, a health economist at the University of Pennsylvania’s Wharton School.

“Will it encourage some weird stuff like some people getting divorced? Yeah,” Duggan said. “That was the challenge of this thing. Where do you draw the line?”

The line was drawn using the 2012 federal poverty level. People with an income between 100 percent and 400 percent of that number are eligible for subsidies when they buy health insurance in the ACA marketplace. That amounts to 64 percent of Americans, said Duggan.

“That is a pretty big chunk of the population that is getting a subsidy,” he said. “They could have extended the subsidy to 74 percent of the people under 500 percent of the poverty line. But that would have cost more.”

One fact that has been lost amid the bumbling of the law’s rollout is that health costs are now rising at the slowest pace in 50 years.

“So overall we are bending the price curve better than we have in 50 years,” Ario said. “We can argue about whether the ACA has a lot to do with that or only a little. That is disputable. What is not disputable is that in the end, people are getting less health care cost increases year over year than they have gotten in 50 years on average.”

Another thing that is clear is that changing the way health insurance is delivered in America is a huge undertaking. Before that change can be made, people have to realize “that there will be a significant amount of destruction,” Ario said. In other words, the country will have to break a few eggs to make this omelet.

“It is somewhat complicated,” Duggan said. “But the hardest time with something like this is in the beginning. Medicare Part D was a mess, a total mess for the first several months. What matters for half of the population is that they don’t need to know the million different provisions of the law. They need to know how to get coverage.”

— Robert Calandra, The Philadelphia Inquirer and Kaiser Health News

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32 Responses for “Another Obamacare Surprise: Married Couples Not Eligible For Subsidies Given Single Filers”

  1. tulip says:

    It makes me wonder how many people will just quietly and secretly divorce and still live together in order to get the subsidy for insurance, how many couples won’t marry because of the high insurance cost and how many gay and lesbiam couples will like having to pay more money for insurance because they wanted the same marital rights as heterosexual married couples.

    This ACA has got to be one of the most ludricrous fiascos in recent history and unfortunately not laughable. I have lost what respect I had for Obama, Congress, House, Senate.

    There will be some who will absolutely benefit from ACA but they are not the majority.

  2. dim wit says:

    “One fact that has been lost amid the bumbling of the law’s rollout is that health costs are now rising at the slowest pace in 50 years.”

    ONE FACT THAT REMAINS CONSTANT AND UNCHANGING IS THAT SALARIES ARE NOT RISING AND HAVE NOT INCREASED FOR ORDINARY AMERICANS SINCE ALMOST ETERNITY. So where are people suppose to find the money to cover the cost of rising insurance cost, food, taxes, fees, housing, and everything else. Now, Obamacare WILL FINE people for not purchasing insurance. Insurance cost may be rising slowly but actual treatment cost is out of control! And folks still have to pay a percentage of out of pocket cost such as deductibles, co-pay, and other expenses not covered/fully covered.

    Stop with the barefaced shilling/!!!!

  3. Tim O'Donnell says:

    You state: People with an income between 100 percent and 400 percent of that number are eligible for subsidies …

    I believe the ACA only provides federal subsidies to those with income higher than 138% of the poverty line.

    http://money.cnn.com/2013/07/25/news/economy/obamacare-medicaid/

  4. Nanci Whitley says:

    “For middle class married couples who don’t have children, the subsidy cutoff is $62,000. A silver-tier policy premium for two can range from $1,150 a month to $2,021, again depending on the plan.”

    One house payment, utility bill, etc. why should they get the same subsidy as one person making 35k?

  5. Genie says:

    And Reid is now marching around exempting members of his Senate staff.

    We don’t have a Constitution anymore; we have a dictatorship.

  6. Gia says:

    National insurance is the answer like other civilize countrys, less then that you’ll have problems.

  7. A.S.F. says:

    They will probably react the way some older widowed people do because of similar laws effecting their social security checks.

  8. Charles Ericksen Jr says:

    The biggest surprise with the AHC plan, will be when participants start incurring claims, and the plan pays only 70%,80 % or 90% of “costs”..

    If you use for an example , where a person incurs, $10,000 in costs, and selected the 70% reimbursement plane, then they will owe , the $3,000 difference between Costs and the 70%,, plus the $5-$12,000 in premiums,

    Bottomline about $15,000 for the year.. Nice plan , Huh ?

    Most employers plans pay easily 80-90% of the agreed upon contacted rates, NOT cost,,

    Then you will see the complaints.. Big Time..

  9. anoun says:

    When will the Dems realize this whole law was not thought out and just stuffed down the American peoples throat.Its a bad law and there is not no way of fixing it.The concept of getting everyone health care is great.There is a better way.This ain’t it.If Mr President keeps on try to sell this.The Dems will pay in 2014.I can’t wait .Time for the Dems to go because their ideas are worse than the Gop.This country can’t afford to stay on this path.

    • grb says:

      And your better way is….I’m listening.

    • A.S.F. says:

      @anoun says–And we’re STIL waiting to hear ONE “better idea” from the GOP in regards to healthcare reform. They seem to be FOR nothing. They are ready to change NOTHING. And all the noise they incessantly make is about what they are against…which is ANY idea put forward by the opposing party (a party which, at least, has some ideas to offer rather than none.)

      • Genie says:

        @ASF: Suggest you check with Reid with regards to the GOP submitting ideas and fixes because THAT is where the hold up is.

        Better yet, check The Federal Register.

        • A.S.F. says:

          Genie says–Historically, Obama has asked COUNTLESS times to meet with Republican representatives in Congress about the implementation of the Affordable Healthcare Act and they have refused. The plan, as it stands today, is based on prior Republican proposals. The truth is, Republicans in Congress simply refuse to budge on their obstinate positions and have proposed nothing of substance or sense to offer in the way of alternative ideas. It was the Republicans, if you recall (although you may not wish to) who shut down the federal government and then, when that turned out to be a disaster (predictably), not only refused to acknowledge that they were wrong but CONGRATULATED THEMSELVES, saying , MISSION ACCOMPLISHED! Despite your reference to the Federal Register, some people need a serious reality check…especially some of the Tea Party bozos in the House of Representatives who have accomplished nothing of note on behalf of our country except the noisy “entertainment” of their tantrums.

          • anoun says:

            I don”t know where you get your info but Mr Obama may call to meet with the Republicans but he don’t listen to what they are saying.He lectures them and tells them its my way or the highway.You know our founding fathers gave the congress the power of the purse not the President.This country is not a dictatorship.It there for checks and balances.SO before you call people bozos you better look in your liberal mirror.

      • Anonymous says:

        A.S.F and grb Well the GOP has had a idea since 2009 try looking at HR2300 .Answer this how smart was to pass a bill they didn’t even read.Remember no republican voted for this so the Dems own this one.They are still finding hidden parts of this bad law.I rather go back to the old way.A least then I would have insurance I could afford.

      • anoun says:

        A.S.F. and grb.Well the Gop has had one since 2009 take a look at HR 2300.Answer this why would you pass a bill that you didn’t even read and know what was in it .That sound kind of stupid.Remember this no Republican voted for this.so The Dems own it.I would rather go back to the old way.At least then I could afford insurance.I take it you like Obama care.If so its because you are befitting from it or it has not effected you yet. If it hasn’t effected you yet .Hold next year it probably will.

        • A.S.F. says:

          @anoun says–I’m so happy for you that you were able to afford insurance in the past. Are you trying to say that you will have to do without any now or that you will be forced to beg in streets because of the Affordable Healthcare Initiative? Thousands of our fellow citizens could not afford ANY health insurance before or had to settle for policies that were virtually useless when the chips were down. What about THOSE individuals? And don’t give me excuses about how they can so easily apply for Medicaid when the governor of our state has turned down an expansion of Medicaid funds…Oh, and,.PS–I do not approve of every aspect of Obamacare. I think he caved in to the insurance company and medical lobbies too much and tried too hard to appease Republicans who he had no prayer of appeasing. I am disappointed in the way the website is rolling out…but I can recognize that the website is one part of a much bigger picture. And the real objective is not to create a nifty website but to provide critical health services to all Americans and not just settle for a system that only extends care to selected groups. Anyone with a heart knows that’s not right.

          • A.S.F. says:

            @anoun says–Just to educate myself at your urging I have had an opportunity to review HR 2300. Here are some of my concerns about that plan: (1) It would prohibit patient effectiveness outcome data and research to be used as a determining factor in treatment protocol approval. (2) There is no mandate or pre-existing condition mechanism built-in. (3)There are no cost-containment measures built-in to address unreimbursed charges for treatment that would be denied (please apply this to the second concern on my list), therefore taxpayers would still be stuck with making up for the costs from unpaid bills (4) HR 2300 also encourages companies to move their employees ontp individual plans…So, I would say to Republicans who love HR 2300 so much, you don’t get to complain about THAT particular sticking point in Obamacare anymore.

          • anoun says:

            A.S.F NO I do not I will not have to beg the streets for food.What I am saying is this bill is a total disaster.It was not thought it was just implemented .It cost a over 650 million dollars and counting and was never put out to bid.This money could of been used to pay for some of the things you speak of.But to used the Idea of rob peter to pay Paul is wrong.ONE BIG QUESTION FOR YOU WHO IS GOING TO PAY FOR ALL YOUR LIBERAL IDEAS. .I know our children and grand children.LETS agree that we disagree with everything political

            • A.S.F. says:

              AGAIN, yet another Republican who uses the ” it will ruin the futures of our children and grandchildren” excuse for doing NOTHING (or worse) about the misery that many “children and grandchildren” live in TODAY! Don’t you want to leave your “children and grandchildren” a better world? The cynical truth is that many Conservatives use the “children and grandchildren” rationale as a cover for their real philosophy, which is, “I’ve got mine, f**ck everybody else.” The problems we don’t deal with today (and affordable healthcare is but one BIG example) is costing us plenty now and will continue to cost us even more in the future if we refuse to do anything about it. Ever hear the expression, “penny wise and pound foolish?” That’s us if we continue to stick our heads in the sand and continue with the the failed policies of “If we take care of big business, it will trickle down to the rest of us and everything will be fine.” That never worked as advertised. Everything is not fine and it won’t get better by doing nothing except sitting home and counting our money while refusing to deal with the urgent realities knocking on our doors.

    • w.ryan says:

      I’ve never seen such doubters in my life. Anything is better than what we had before. You doubters won’t realize until you or a family member suffers a catastrophic illness and you stand to lose everything! We should have a one payer system anyway!

  10. Bob Z. says:

    You cannot please all of the people all of the time….no matter what rules they would have come up with people would have complained.

  11. fruitcake says:

    and who exactly is paying for the subsidies? where does that money come from?

  12. fruitcake says:

    Get used to these types of things surfacing …the worst is yet to come

  13. rhweir says:

    We don’t qualify for subsidies. Combined income of over $62,000 which by the way is not much money even in Palm Coast. Instead, both our premiums increased. Such a deal Obama! Saw an interesting stat the other day, Palm Coast MSA was third in the country in lost jobs for FFY 2013. I think it was 3.8%. We’re supposed to be creating jobs around here not losing them.

  14. Bunnell Resident says:

    The ACA formerly known as Obamacare is great news for the country. The absolute ineptitude of Dumbocrats will finally be exposed in all it’s glory and usher in a new era of Republican rule.

    • A.S.F. says:

      @Bunnell Resident says–Oh, yes, we should all look forward to the day when we can elect someone like Rick Santorum for President, who just compared himself and other oppressed Republicans in Congress on Thursday to Nelson Mandela, or Michele Bachmann, who is just absolutely crazy, or Mitt Romney, who straps his dog onto the roof of his car and speaks disparagingly about the lazy no-good 47% of Americans who are holding back those long-suffering successful business people who are the REAL patriots, or Sarah Palin…Well, need I say more?

  15. w.ryan says:

    It ‘s amazing…wasn’t Obama care a Republican plan? But since President Obama adopted it, it’s no good??? Oh…I forgot…you guys are taking America back…regardless of you dying of illness of whether you go bankrupt because of medical bills in the process. Can’t have a black man in charge of us!!!

    • Shocker says:

      Really? And after all of this, all you see is a “race card”? ALL people are going to suffer, Dems, Reps, Liberals, Tea Party… It does not matter. I am so tired of race being a part of everything. This is about the financial stability of our OWN country and our OWN people. No one elses. Leave the friggin race card where it deserves to be… ALONE!

      • w.ryan says:

        @Shocker: If you have not experienced “race being a part of everything” don’t speak on it. Ignorance is bliss! Aside from the fiasco in Washington and the Stop Obama Campaign and the “just say no” by congress what do you think is going on??? Filibusters and the slogan “Take America Back” speaks for itself. But keep up the rhetoric and keep the rose tints on. The facts are that Romneycare/Obama care has to be tweaked as it is improved. But millions are being helped in the process of this implementation. Speaking of these minimal incidences melign the facts. We will now naturally bring it home to Socialism but I bet you’re on Social Security. I’ll call it as it is. With the welts on my back and the scares in my memory, race is a part of everything. As I understand it, now we have another complaint about subsidies whereas there was no subsidies before Obama Care. You folks reminds me of Monty Python’s Black Knight without the noble cause.

  16. A.S.F. says:

    @Shocker says–People don’t leave the “race card” alone because it is still an issue in this country. The Republicans who scream loudest and most indignantly about the “race card” are like children who whine that Mom is being unfair in accusing them about spoiling thier dinner when they’ve got a cookie in each hand (behind their back.) Pretty it up all you want by calling Obama a “socialist”, whine about birth certificates and college transcripts and listen raptly and gleefully for any tidbit that you might be able to pounce on that PROVES (in your mind) that he’s loser who is out to destroy our country. Rooting for our President to fail, saying it’s A-OK to shut down the entire government at the mere suggestion that he might actually do what he was freely elected to do by the majority of Americans shows who the REAL traitors to this country are. Don’t like The Affordable Healthcare Act and think you can come up with better suggestions and ways to improve it? By all means, don’t just complain; give us the specifics!

  17. A.S.F. says:

    …And, now, for the REAL kicker: News outlets are now reporting that Marc Rubio has signed himself and his family up for the subsidies offered to congressmen and their families through the new D.C. healthcare exchange. Yup, he’s totally oposed to it on principle but…”Do as I say, not as I do.”

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