WWL>Topics>>2-20 1:10pm Angela, Affordable Healthcare

2-20 1:10pm Angela, Affordable Healthcare

Feb 20, 2014|

Affordable Healthcare – are you in compliance? The signup and enrollment dates loom large…do you have proof of insurance? Do you know the final deadline before you get a tax penalty? What exactly are those penalties? What if you signed up, but haven’t received your card yet? And, what options do you have if your health insurance policy is cancelled? We have the experts to answer your questions, Gabe Janusa, Patrick Taylor and Kyle Pomerleaau.

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Automatically Generated Transcript (may not be 100% accurate)

The sun is shining. Spring is on the way life is good. And the next two hours are going to be great because we're going to be talking once again about the Affordable Care Act. This is Obama care we have committed almost seven hours this far in this program. But it's just real real important and whether you're signing up or whether you have your own insurance things are changing and I think we need to. Fully discuss -- it's also a great opportunity for you to give us a call if you have any questions. Or any thought to -- have to be a question. Because another deadline is looming for Americans to make sure they're covered buying insurance by march 31. March 31 is. To prove you have health insurance or face a fine. This is the new world of the Affordable Care Act or Obama care since last fall. We've been doing these shows in an effort to help those signing up in the marketplace. And to answer questions about eligibility. Well today our two experts and friends. Are back to spend the next two hours with this and they're here to help you. Whether you're an individual or business with a question please give us a call 2601870. Or if you've signed up and are now in the bronze silver or gold plans call and let us know how it's working for you. Again that's 2601870. Our guest Patrick Taylor president of benefit planning group and gave -- president of demand insurance benefits and I just said to them. I need my Patrick in gave facts about once a month -- a but I tell you. I've learned so much for me as I know our listeners have and yet there's still much to learn and in part because this seems to be morphing a little bit. And some other changes we hear about looks kinda started the beginning now and tell me since we last met. What are -- Well I've seen particularly some additional capability through the health -- like -- web site. They've actually they've always had two buttons on there but they really had no use whatsoever there's two buttons -- How to pay your first premium and how to reporting -- change you know we went through since October. November December January not having the ability to use these two buttons -- money was to give birth to a child. Last month the so they couldn't report that changed he would have to go directly to the insurance carrier. Now you had this capability through the web site to reports -- north specific changes. Those being you know if you change your citizenship or immigration status. You need to and remove a member of your household. May be you got married Horry gave birth to a child you adopted the child. Gain or loss of your group coverage at work you know these are all different events that. May actually take place. After the open enrollment period in as you know the open road period actually ends march 31 so what is life after march 31 what changes can you make. These bugs will allow you to modify your coverage. After open enrollment now -- that you know people having the ability to actually pay the first. Months premium where before they Wenatchee half to -- They check to the insurance carrier in the memo section. And some specific information related to their policy their application -- things like that. Now they get paid the insurance carried directly which in my opinion is much more efficient. Patrick well. We're not leasing checks being lost in the mail any longer but we're getting policy numbers of events out of 45 days which is really nice sometimes a little bit longer than that. I think that the beauty of all the changes that we've seen them -- the warmest wonderful aspect of all of that. It's a fact that we are enrolling people now. Were saving people a lot of money were having people and this has happened with gay people walk out of our offices with tears in their eyes. For the first time in my thirty year career. I'm able to tell people you know what I'm saying I'm gonna save a lot of money any health insurance premiums in your benefits are going to be better than they are today. And they just -- pitch in amazement. Went full disclosure -- to you we can't help everybody the bottom line you know. You think we can't I mean we we'd love to but we can't you know -- law does allow us to advocates sometimes he would just can't even afford the premium. After the subsidies taken -- consideration is correct so the bottom lines of consular qualified person to you know they can't afford the premium and also we again we can't help everybody but. Give us the opportunity to help you see if we can help -- Let's talk about. The numbers who have signed up its effort just like four million is that roughly what was anticipated at this point. I think it is anticipated you look less Lou -- more than that actually what what I'm hearing is that seven night the prime more Medicaid. Enrollment and actual. Health insurance enrollment. That's correct and -- -- -- people cannot afford exactly which of just saying they can't even afford the lowest premium with a subsidy. They can get into Medicaid. Don't know that cannot get into Medicaid that's on the most important things remember if you are below the federal poverty level which for an individual that's 111470. Dollars. For a two for two people and families around 151500. Dollars if your income falls below that. You do not qualify for Medicaid you go to charity house. Okay. I think I'm vaguely remembering this conversation earlier and yes there's just some people slipping through the cracks another irony to me is. I thought that a great deal of all of this whole movement. The they have recovery thing is. To capture people who desperately need. Insurance. And so we're still letting some people slip through well I think up. Pat -- -- -- the -- sent Helen the producer of the show substantial questions of the things he scenes where you have. Maybe a spouse that is enrolled in Medicare. But there. Other spouse obviously you know was uninsured on the past and now you know what these new provisions they have guaranteed coverage. Into the market so people that wanted to make it covered before. Now have access to coverage. So what what you're saying is if someone was on Medicare. And that the spouse was on Medicare. Now let -- -- an example of it's of a husband and wife why this 57 has been 65. He's recently retired. He goes on Medicare. The wife -- spousal benefits. She goes out on the on the the open market to buy health insurance she doesn't qualify for because of preexisting conditions and or it's too expensive. That group that segment of the population on seem more of that right now than anything else where were able to now ensure that spouse. And we're used in the the federal government actually uses the income of the retiree and the income of the spouse when determining this substantive subsidy subsidy eligibility. On in in most cases they're fairly large subsidies. And the nice thing is is the spouse gets full health insurance coverage without any pre existing conditions. It's antique effort that that is wonderful I think the preexisting. Thing is the greatest part of this whole thing is they were just people who. Had problems but couldn't get insurance and that was wrong. Let's get some of our callers Travis. Yes yes. There are two major point that's fine it is not ruling in this case. If we wanna make our health care affordable side has got to start ruling and the first thing that these ago and I'm a doctor his. Cardiac bypass surgery. I don't know what they produce on now what years ago. 20% of the Medicare dollars ports. Spent psychotic bypass surgery doesn't extend life by one day. It's pointless. And they only take it should be used and like everything in Madison and there is an exception in the young patient who has a genetically small. And no single vessel disease. Then you know you can -- caught it bypass surgery and the rest of the patient it's been proven by science. Not to extend life by one and yet of course when Nixon Medicare adult. The second thing is. That job -- like governor and a bright -- present have moved -- Come into the realization. That we are putting out to -- And. We have we didn't beat me. What did you think about the need to cut off. Okay -- are we should have. I'm sorry you know by -- doctor so I like to know people keep calling him. And right we should have 50% specialists and 50% primary care and yet LSU. -- -- go over a couple of learning. Which continues to to generate. 85%. Specialists. LSU should be producing a 100% specialist. I'm a 100% primary care until we get up to 50% specials. Again and that they don't. Don't wanna go into primary care and they should be paying like two -- and our governor and our president and a quote proved. Medicare subsidies. Why aren't subsidizing these specialty programs. Our our federal government pay for the specialty programs we have got to stop paying for. Primary care programs paying the primary care doctors more and stop paying for a tour -- residency programs for a specialist. -- -- the problem is is that the primary care doctors don't make as much money as is specialist. And -- people finish through medical school they Kenneth Thomas in loans again payback. The fastest way to pay -- back it's either don't work for the military angle crossed you know to another content continent or. -- specials. But I think there is a real awareness nationally that there is a need for. -- family doctors internist at -- -- And that there are up efforts to try to. Pull people that way but I agree with -- it is about money in these kids do finish at half million dollars reporter million dollars and specialists get paid more. And in some cases and correct me if I'm wrong but I also think we're hearing more and more from doctors who aren't being paid enough through insurance companies or -- Medicare etc. that you know they're not controlling their old system. Hit it in Denmark. Primary care doctors are paid the most but brightest people go into primary care which is the way it should be because. They aren't treating people for a variety of things different to -- the system should work. You know and you know they keep. You know the government to saint -- on increased reimbursement for -- primary care. They don't. Do it. Increase reimbursements for obamacare. Stop paying -- specialists. Programs through Medicare. Stopped you know. You know paying for. You know. Residency programs and LSU. The through the government. You know I mean. Here's doctor -- and sir I really hear your frustration and I truly appreciate this phone call and we're gonna have to move on but never hesitate to call it. Don't ever lose that passion thank you very much let's go to Tony on the West Bank. I don't expect much albeit to capture of god yet on hurt when you're gonna -- about forty minutes ago. They had mentioned -- the comment and I wanted to direct this question until the acute interest I noticed that their expertise I'll look a little confused. You know the normal personality. Is I was always under the impression that Obama that was created because the government was forcing everybody having insurance the -- that you read in the paper read -- newspaper and magazine kind of on the local. Laws that. If you did not yet. Insurance you're you're gonna be charged. Optical period individual as a taxpayer and opera quality insurance -- that the government that. If you value under a property bubble you you know he does -- not different you know figured the only good thing Colin. And you know you may get -- -- you couldn't get you know Medicaid. Or Medicare if you if you want an apocalypse. -- -- to charity hospital I thought that all Obama it was put in the light does Bobby issues like there. Obamacare was put in -- place to solve that was one of the issues it was also put in place to solve the issues of the uninsured that were -- able to pay for health insurance however they had preexisting conditions which -- keeping them from being able to buy health insurance. On most of the people. That. Are eligible for Medicare have been eligible for Medicaid in the past. The vast majority of those people -- of -- still going to be eligible for Medicaid. And door charity hospital -- benefits so we're not talk to people out in the community and they say well I don't have medic medic dating longer but I still get together candidate. To the community hospital last took it to pay co pay when I see my doctor. That's very similar to what they were doing with Medicaid. -- not a quick question to our next question -- -- you'll have a the call the YouTube and my next question Annapolis and yell response. A lot of them on. Any politician. Up in Washington may draw a law but I think the problem with I'm on medical system and and got bit in this country is the working man in -- the I think the people. -- you know go out and work and the idea in the recent past that dominated the eagle went OBJ life and -- And and you sit there you know when you white you know -- companies seeing a lot younger girls come and operate it. And then got it maybe in the stroller. And an -- to an -- -- one or Khatami and what they -- they bought them but it guard. I think that we could solve the nation's problem as when these young girl. Nationwide at one baby. The government should say you know what we're -- -- 100. You're gonna go ahead and -- June hysterectomy. And as it's fall a lot of the problem to get beat. Younger continued have been in via the baby after baby and it's gonna pay -- form every month. Okay Tony thanks so much for your phone call. I don't respond to something like that that. OK in my hands or on the opinion they're entitled to with painlessly noted that that's right this is America by golly and this is an open mind and we're gonna keep an open mind. But I I appreciate Tony's call in it's interesting to listen where people think our money health care money is going. And in his mind -- is in children having children -- -- young girls having children. And our previous caller it's too many took heart bypasses that are unnecessary. -- -- We learn live and learn and we are now joined by Kyle Palmer -- who has an economist at the Tax Foundation. And I really appreciate you calling because earlier this week we had done a program on we just talk about federal -- just in general and talked with thought what the chief economist there. Any started talking about Obama care and Howell was being funded etc. And I said oh you know what we need to further discuss that and Kyle you were nice enough to join us today. To help explain sort of how were held were paying for Obama care. -- well thank you very much for having me. It's my pleasure to be here and talk about that. You're looking at it from an economist point of view. Meaning. Yes so and so when I would hit it obamacare. I'm looking at not not only just how it affects individuals but how it's going to affect the economy in general so Obama carried in massive. Bill it has tons of moving pieces lots of taxes subsidies regulations. And the goal of these world they you know they are put together in order to lower the cost of health care and help people become T shirt. But the problem is there one of the big problems as you might as their chief economist probably described yesterday or day before is that. At this is very very expensive. -- these taxes over about a ten year period. Are about a trillion. Additional dollars. And it's these specific if you would about. About the taxes this was what was so eye opening to me. -- in the taxes range from. Additional income taxes to business taxes. Make it in -- things are such as. We have an additional point 9% payroll taxes on the wages and self employment income. And a new three point 8% tax on dividends capital gains that alone is going to raise a -- -- -- -- around 33. 320. Billion dollars over ten years but we have eight. What is called Cadillac tax on high cost on health insurance plan that's but -- hundred billion dollars. If the employer mandate that's supposedly going to raise hundred another hundred billion dollars. We have another tax on insurance providers under another hundred billion dollars the individual mandate. Which is the tax penalty for not having insurance they're going they assume that that's been raised fifty billion dollars. And the list goes on and on there that are. They're up about a little bit more than a dozen of these taxes that are that essentially affect everyone across the economy. I don't think everybody was aware of that I'm sitting with two incredible independent insurance people. You just mentioned that one of them one's going to be a tax on the insurance providers were you too aware of that absolutely imminent and direct taxes and increased premium. For the injured right off the bat but this is this is official as of today I mean these taxes are in for 2014. Yes. If not for 2013 for 2014. So next year when we do our taxes if we have capital gains in same are going to be paying three point 8% well that's that's for higher income earners in a negative income over 2000 miles more than a game it was an additional Medicare surtax of three point 8%. You know. And that's and that's been. And and that's been attacked since January 23 -- right so that's something we've -- were already dealing. It my concern is that they keep changing things -- mean the goal post is constantly moving you know 12 we haven't employment -- for. The floors more than fifty employees and that -- we hear it's only four. Groups with a hundred or more for just this you know upcoming year 2015. So you know again they're moving the goal -- that's less revenue for the federal government you have to think there's some political you know maneuvering there because in the mid term elections coming up not to yeah. -- its cost indeed the businesses as well I have businesses that are renewing their groups this year. That their plan mr. renewed this year and become obamacare compliant this year. And now we're in the middle of those enrollment periods and Obama his comments -- we're gonna move then mandate that back to 2016. Talk about confusing to businesses and. Yeah and that that that has some longer term implications for businesses need to plan. Into the future but when the president is able to change the law so drastically at such short notice. It affects what these decisions are going to be and dissect it and that that affect the broader economy when businesses can't. Can't I predict what their investment opportunities or what their costs are going to be within just a year. Look I'll have a question for you. You know what I think's gonna be a challenge for a lot of individuals or families come tax time not this tax period but a connection -- the following their. 2014 tax return April 152015. Is that in the event people have to repay a subsidy in to this day the IRS is not creating a worksheet. An individual can use step by step to see if there's some type of repayment of that subsidy Mickey's Turbotax -- into it or whatever else is out there. You know there's a lot of different worksheets inside that software. But does to this day there's still no such worksheet. Are you seeing anything like -- second be available from where you where you stand. So it's so we also have not seen something like that and that's that's one of the things that's very concerning about how this. The subsidy works and I don't know if you guys had gone into it but that the way this subsidy work is since it's essentially a refundable tax credit. Where you pay you sign up for insurance you have the option either have -- BI -- paying the insurance company directly for the coverage for. You can. You get the subsidy at the end of the year like QQ with other refundable tax credits now the problem is that you -- that's sort of predict future income is going to be because the sub the refundable tax credits based on your income. So if you get your income wrong if your income a little higher than you otherwise thought it was going to be he got a second job or you've got a bonus or something like that. The direct path to take back some of that subsidy that they have already paid the insurance company. -- what -- -- there are some caps on some of those repayments but based on the one China -- night Kaiser. In particular there's one -- where some nice income exceeds 500%. Other federal Pablo and at the pain that subsidy in full that he. I mean and the only nation Messina does that mean that a person would literally -- to check back to the IRS or did they just take back. If you have a return. So so far what I've what I've heard it I'm not an expert on the regulations this stuff is that the -- only has the authority. To. Reduce your refund. You can't that you can't they are they don't have the authority to meet you write an additional checks. Okay more than it's confusing at I think as a layperson. It's beneficial -- -- very beneficial. To the consumer not necessarily -- -- to the the share responsibility payment with the individual penalties well all make it -- -- at. You know people can really structure -- W forced to minimize how much are actually sending to the government. -- -- -- -- -- -- They can actually prevent actually payment penalty by doing that properly but they expect the 5000 dollar refund but come tax time. You know the bottom line is if they get the payment -- a subsidy or there was Italian pay they're gonna take. They're gonna get less money in terms of -- I'm gonna throw something out were quick a scene and talked to an awful lot of self implode. Boy people and over the years what is the general concept then -- to have as many deductions as possible so we minimize the income taxes correct. And they done that to the tune of three decreased -- -- of the federal poverty level. What are these people going to do today. They're not going to take as many deductions. So that they get their income over the federal poverty level. The that the downside to all of that is what if they actually don't make pink cup. And they didn't qualify for a subsidy how is the IRS actually gonna treat that in college -- correct there's no real. Documentation out there are perpich telling us what's gonna happen. Except it affected I think the maximum that penalty taken. Charged back to you is 2500 dollars if it's. Not criminal. Yanks you're yeah you're correct the only thing we know is. The amount of their -- allowed to charge we we haven't seen -- I haven't seen how this is going to be implemented which is. Just cause for concern. You know refundable tax credit in the way the higher handle these things is not. It's not. Has made good in the pac. Stand a good -- -- another tax credit that has a lot of these same issues were talking about is that -- the earned income tax credit. Your end of income tax credit which hate people. A refundable credit based on their income and you file for the -- and get the money back the end of the year. There's been a lot of confusion as to beat you know for when filing that you know what. How he defined a defined a child what your income level is and there's a lot of -- and in also there's a lot of fraud people change their incomes or. Or claim an additional child in order to get more money in the same thing can happen. The tax credit here -- obamacare. It is now and we have another deadline which is march 31 and that's why primarily were doing the show was too. For anybody who still must sign up for anybody who has questions about insurance we have our two super experts here Patrick Taylor. And gave Jim -- But we're also joined right now by Kyle Palmer who was an economist with the Tax Foundation and -- once again thank you so much for joining us. What we're talking about now. Is what is this costing us. The simple -- that I am is okay. My insurance premium is helping pay for the load -- and in reality. Many taxes. That all of us are going to feel one way or the other. It's gonna is gonna cost to self correct. Absolutely okay that would have yet in that out of the planet's posted the entire law is supposed to. Sort of shift all a lot of the costs of health care round in order to. Redo this system's central. So we're not lowering the costs of health care. We're just shifting -- Well there are there are guys. Pieces in there that are supposed to help lower the -- one of the theories behind health insurance is if you make insurance. Too generous. It lower it it it economists say it lowers people's demand curves in May be they consume more insurance than they otherwise would have. Because they're not facing the true costs. -- that that increases the prices overall and obamacare is supposed to tackle that among other issues while lowering the cost of course. Some people question whether this is actually going to happen but that is what they -- it's supposed to happen. The main things we've talked about every time we gonna show us what obamacare does. Which is a good thing is that it allows people who had precondition -- pre existing conditions to get insurance who were not able to before. That but it is also. Banking on younger people being part of it -- hearing that only about 25% of those who have signed up. Are in that young age what happens. If we don't get their participation. So this is this is actually the core of obamacare so obamacare is sort of this three legged stool and you talked about one of them is. It's guaranteed issue and which -- you can't deny someone based on preexisting conditions. The second pieces something called community rating but doesn't allow insurance premiums to vary too much across different age are. Across different people essentially you can -- it I think by. Certain degree by age and by smoking status and in the third piece is the individual mandate. Obamacare would banking on the fact that the individual -- -- mandate was going to force enough young people into the insurance pool. And that was going to. Spread the risk around more than it otherwise. Or it currently had band that was supposed to lower premiums. For. The thicker and more elderly insurance eye insurance holders -- but. That doesn't seem to be happening right away. And you're right there we're not we're not seeing the young people attempting to enter networking some of these these silly ads. That are trying to encourage. Young people to sign up for insurance because they're really. They really need young people to get into the insurance -- to drive down the cost. You know I literally just read something before we came on the air about the efforts going on to try to get on people and an Austin, Texas they're doing a pub crawl her. 'cause they're gonna go where the young people art to see -- Sino. But in a column -- talked a lot of young people and the young people in word that you're seeing on commercial Symbian to altered from publications that. The penalty for not signing up -- 95 dollars or 1% of your income whichever is greater. Now whenever explains that 1% or greater. I have not done the math no one's going to be charged 95 dollars because if you were charged on five dollars a Manger income is only -- 500 dollars a year and you're not out if you don't you're not required to buy health insurance anyway. So that means everybody's going that did that doesn't purchasing insurance. Will be paints penalties of more like a 1020300. Dollars based on their income. So in other words when they fill out their tax income tax this year and if they don't have proof of insurance. They're gonna get the 1% penalty. It's it's got to be 1% felt as if if it's 95 dollars they would have to buy the insurance anyway so when they think they're getting -- back. And it's not that her then -- the message will be met and so a young person's making 25000 dollars a year is going to have a 250 dollar penalty not in 95 dollar penalty and I think that the public needs to understand that. Very important Kyle just your final thoughts on I'm so appreciative of your time. Any of the things you would like to say. No I think I think in general people have to be aware just how these these. The general mechanisms of Obama care how they work -- of course we've all heard how it they're going to affect individuals. But Obama care is a very large. Piece of legislation and it affects. Through either taxes or the subsidies or the regulation effects. Every one in infect the entire economy that's something to keep in mind and in -- -- tons and tons of moving pieces in this piece of legislation. I'm so -- -- it -- the reason you're seeing that bad that government having so much trouble. It because it's just it's so much for them to take care of and it it's it's very doubtful that they're going to get everything right. -- Palmer -- from the Tax Foundation thank you still very much for joining us. We're gonna stay in touch with -- I want everyone else to stay with this will take another break but come back any questions or thoughts you have on Obama care give us a call 260187. Day. I'm Angela under the WL.