Obamacare FAQ: Your Questions Answered on KQED’s Forum

(Getty Images)

(Getty Images)

Just a week to go. The deadline to enroll in health insurance starting Jan. 1 is next Monday, Dec. 23.

This morning on KQED’s Forum, Emily Bazar, of the Center for Health Reporting, and I answered listener questions about enrolling in insurance via Covered California.

Host Michael Krasny started by asking us some of the basics. Yes, you can still buy coverage after Dec. 23; open enrollment runs until Mar. 31, 2014. After that, if you don’t have health insurance, you will likely need to pay a penalty, $95 per adult or 1 percent of your income, whichever is greater.

But we quickly got into some specifics. One listener said he had been buying a separate health insurance policy for his two young children, but their policy was canceled because it did not comply with the ACA. New policies are significantly more expensive. In addition, he has employer-based insurance for himself — but his employer’s insurance is very expensive for his family.

It was that last bit of his story that put him into the “kid glitch.” If your employer offers you “affordable” insurance, and they also offer coverage to your dependents, even if the dependent coverage is very expensive, you do not qualify for subsidies on the Covered California marketplace.

Another caller wanted to know if she bought insurance, if her son who goes to college in Portland, OR would be covered. Bazar explained that some plans offer a multi-state option, and consumers should be sure to check what is covered outside California.

More than one caller wanted to know a variation of “who’s in my household?” In short, your eligibility for a subsidy is determined by your income and household size. In short, your household is determined by who you claim as a dependent on your federal income tax return. So, if you claim your college student daughter as a dependent, you must also claim any income she might earn.

Another caller wanted to know why her children qualified for Medi-Cal but she and her husband did not. While adults who earn up to 138 percent of poverty are eligible for Medi-Cal, for children the threshold is 250 percent of poverty. Here’s an example: say a family of four has household income of $55,000. That’s much more than 138 percent of poverty — and just under 250 percent of poverty — for a family of four. So, the children qualify for Medi-Cal, but the adults must buy on the Covered California marketplace. They will qualify for subsidies to help them afford insurance.

But many people had questions that Bazar and I simply could not answer. If you’re having trouble with your specific question, we both encouraged listeners to seek in-person assistance. You can click here to visit Covered California’s links to find someone near you to help you.

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