People whose 2014 income will be a little too high to get subsidized health insurance from Covered California next year should start thinking now about ways to lower it to increase their odds of getting the valuable tax subsidy.
"If they can adjust (their income), they should," says Karen Pollitz, a senior fellow with the Kaiser Family Foundation. "It's not cheating, it's allowed."
Under the Affordable Care Act, if your 2014 income is between 138 and 400 percent of poverty level for your household size, you can purchase health insurance on a state-run exchange (such as Covered California) and receive a federal tax subsidy to offset all or part of your premium.
If your income falls below 138 percent of poverty, you qualify for Medicaid, which provides no-cost health care to low-income people. In California, it's called Medi-Cal. If your income is higher than 400 percent of poverty, you can purchase a policy on or off the exchange, but in either case, you won't get a subsidy and the policy must provide certain essential benefits that many low-cost individual policies lack today, such as maternity care.
For older people, getting below the 400 percent poverty limit could save many thousands of dollars per year. Take, for example, Jacqueline Proctor of San Francisco. She and her husband are in their early 60s. They have been paying $7,200 a year for a bare-bones Kaiser Permanentehealth plan with a $5,000 per person annual deductible.
"Kaiser told us the plan does not comply with Obamacare and the substitute will cost more than twice as much," about $15,000 per year, she says. This new plan, Kaiser's cheapest offering for 2014, would consume about 25 percent of their after-tax income.
The new plan still has a $5,000 deductible but provides coverage for things her current policy does not, such as maternity care, healthy child visits and coverage for dependents up to age 26. Proctor has no use for such coverage, since her son is 30.
Premiums are also going up for many people next year because insurers can no longer deny coverage to people with pre-existing conditions or impose lifetime coverage caps.