Barely a month old, the Affordable Care Act has had a rocky start, to put it mildly.



Confusion, technical glitches and slow wait times have hampered consumers’ ability to enroll in plans. Contractors who worked on the government’s insurance marketplace testified before a U.S. House of Representatives oversight committee last week that the site was launched without sufficient system-wide testing. And this past weekend a data center supporting HealthCare.gov had an outage, which meant people trying to sign up couldn’t complete the process. As of Monday, the issues were resolved.



Secretary of Health and Human Services Kathleen Sebelius is set to testify before Congress on Wednesday and will acknowledge the difficulties so many consumers have experienced in signing up. She will also ensure her team has been working to meet demand and address the existing sign-up issues, according to her prepared statement.



Adding yet more fuel to critics’ calls to push off implementation of the ACA, NBC News reported on Tuesday that, despite President Obama’s assurances in 2009 that Americans would be able to keep their health plans if they liked them, the administration knew many consumers would have their plans cancelled because their existing policies don't meet the standards mandated by the new law.



While the government works to improve HealthCare.gov and deal with the political fallout from its messy launch, we’re continuing to answer readers’ questions about the law and the exchanges, and we want to hear from you.



Have you tried shopping for a health plan on your state’s marketplace or HealthCare.gov? Tell us about your experience: Did you encounter technical problems? Were you successful in purchasing a plan? How do the costs compare? Email us at obamacarequestion@yahoo.com and check out our answers to readers’ questions below.



Q: Is turning 26 in 2014 and losing parental coverage considered a “qualifying life event” for plan enrollment later?



A: Once you lose eligibility as a dependent, you will qualify for a special enrollment opportunity, according to the Kaiser Family Foundation. You’ll then be able to apply for coverage and assistance through the marketplace, even though it will be outside of a regular open enrollment period.



Q: I retired January of this year. Currently receiving railroad retirement and a small annuity from my former employer; additionally I withdrew some funds from my 401k — are these considered part of MAGI?



A: Retirement income sources are generally counted as MAGI. Sometimes a portion of pension benefits or 401(k) distributions are not taxable (if some of the person’s retirement contributions while they worked were made with after-tax dollars), says Karen Pollitz, a senior fellow at the Kaiser Family Foundation, a health policy nonprofit. “The retirement plan should indicate which portion, if any, of the distributions were non-taxable when they send the 1099. Otherwise, it counts,” she says.



Q: My income is 120% of the federal poverty line. Can I choose to buy insurance on the exchange or do I have to go on Medicaid?



If you live in a state that expanded Medicaid, you should pick Medicaid, Pollitz says. You wouldn’t be eligible for subsidies through the exchange if you’re eligible for Medicaid, she says. But if your state hasn’t expanded Medicaid, you should enroll via your state’s exchange; you would be eligible for “extensive premium and cost-sharing subsidies,” she says. Click here to see if your state expanded Medicaid.



Q: I have employer-provided health insurance. My husband does not have insurance, [it’s] too expensive through my employer. Will my income be considered when he enrolls for coverage? And even though pre-existing conditions are covered, does the coverage begin immediately or will the insured have to wait one year to get the pre-existing conditions covered?



A: If your household income is less than 400% of the federal poverty level, or FPL, (about $62,000 a year for a family of two), and if your employer prohibits you from enrolling dependents in the plan, your husband may qualify for subsidies. If your household income is greater than 400% of the poverty level, “you’re out of luck – it’s total household income that counts, not your husband’s personal income,” says Carrie McLean, director of customer service at eHealth, an insurance shopping site.



If your employer’s plan is open to dependents but the amount of money you contribute to your own coverage under your employer’s plan is less than 9.5% of your income, then the employer plan is considered “affordable” under the law, and your husband would not be eligible for subsidies, even if your income was under 400% of the poverty level. Even if the amount you would have to contribute toward your combined coverage under the employer plan is greater than 9.5% of your income, he won’t qualify for subsidies. This is a known glitch in the law but it’s not known when or if it will be addressed legislatively, says McLean.



To answer your other question: Coverage of pre-existing conditions can start right away for new plans in 2014. Please note that, for individually purchased plans with coverage starting before January 1, 2014, you may still be declined due to a pre-existing medical condition.



Q: I have a question about how to define household income for Obamacare. My husband is retired and on Medicare, so he won't be applying. I am applying for myself and our two young kids. I don't have insurance through my employer because I only work part time. Because I am applying for myself and my two kids, not my husband, I am wondering if I have to use our combined income for our household income or can my Obamacare application be based on my income alone? We file our taxes jointly and we do receive Social Security.



A: This answer is similar to the preceding question: In your case, household income includes the MAGI (modified adjusted gross income) of the taxpayer (you) and also any individuals for whom a taxpayer claims a personal exemption on the federal tax form. So your husband’s income would be included in the determination of household income even though you’re not seeking insurance for him, says Mark Luscombe, principal analyst at Wolters Kluwer Tax & Accounting.



Q: What happens if our estimated income for 2014 changes, to either higher or lower than expected?



We assume you’re asking about how a change in estimated income might affect your subsidy eligibility. The Kaiser Family Foundation recommends reporting any income changes you experience to the marketplace during the year, as they occur. Otherwise, if you claim a tax credit during the year and your actual 2014 income edges over 400% of the federal poverty level, you’ll need to pay back the full credit amount. To avoid that – and if you estimate your 2014 income will be close to 400% FPL – you could consider waiting until you file your 2014 taxes to take all or a portion of the credit on your tax return instead of receiving advance payments, the KFF says.



Q: I work, and get coverage through my employer. My husband is a student and he has zero income. My employer offers coverage for my husband, but it costs a fortune. We are a family of 2, and we make about $57,000. Is my husband eligible for coverage through the exchange, and does he qualify for any tax credits?





Similar to a previous question, you can shop for insurance on the marketplace, but if your husband is eligible for coverage through your employer, he can only qualify for premium subsidies if the employer’s plan is unaffordable. Coverage is considered unaffordable if the cost of coverage for you (alone) under your employer’s plan is more than 9.5% of your income. So if your health plan costs you, say, $5,000 a year, that’s less than 9.5% of your $57,000 income ($5,415), which means it’s not considered unaffordable, according to the law.



Since your husband is a student, he may be able to enroll in a health plan offered through his university.



Q: My question is: Do any of the tax subsidies and credits apply to individuals enrolled in a private plan (either on their own or through their employers) but NOT through an exchange? I've seen a lot of concerns about providers raising premiums and I'm wondering what assistance the government is providing to those who may see their premiums increase even though they remain enrolled in the same plan as before.



A: Subsidies are only available to consumers who buy plans on the exchanges.



Q: I am on SSD [Social Security disability] and have Medicaid for insurance. Do I need to apply for the new health system or does this not have an impact on my current insurance?



A: If you get insurance through Medicaid, the health exchanges don’t affect you. Note that under the ACA, Medicaid eligibility is expanding in many states, so more people will qualify for Medicaid starting in 2014 https://www.healthcare.gov/do-i-qualify-for-medicaid/.



Q: I currently have COBRA and would like to switch over to Obamacare to reduce my medical cost. How do I go about doing that? Should I apply for open enrollment now and cancel my COBRA in the meantime?



You can drop your COBRA coverage and buy a plan on the marketplace during the open enrollment period, which ends March 31, 2014. You’ll have to drop your COBRA effective on the date your new health coverage begins. Check your state’s exchange or HealthCare.gov for application information and to see if you qualify for subsidies.



Note that, after open enrollment ends, if you voluntarily drop COBRA or stop paying premiums, you won’t be eligible for a special enrollment opportunity and will have to wait until the next enrollment period. Only exhaustion of your COBRA coverage triggers a special enrollment opportunity, says KFF.



Q: If I leave one job for another job and the new job has a 90-day waiting period for their insurance to start, should I pay for COBRA for that 90-day period or get coverage through the marketplaces for that 90-day period?



It depends. If you think you’ll qualify for subsidies, it might make sense to buy a plan on the marketplace. You could apply for a subsidy, but your eligibility would end once the waiting period at your new employer ends and you can enroll in an insurance plan, says Pollitz of Kaiser Family Foundation. (Just note that, if you do buy a plan on the exchange, there’s generally about a two-week delay from the time of purchase to the time you’re actually covered.) If you’re not eligible for subsidies, COBRA might make sense; there’s no change in your provider network and you wouldn’t need to restart the annual deductible as you would if you switched plans, Pollitz says.



Q: I am self-employed and have income that can vary wildly, from month to month and year to year. Can you tell me exactly what formula is used to determine the income requirements for subsidies and penalties? Is it the current year's annual income, the prior year's annual income, or something else?



A: This can get tricky, especially for self-employed folks whose income fluctuates as yours does. If you overestimate your 2014 income, you may not qualify for subsidies, and if you underestimate what you’ll make, you risk a bill from the IRS asking you to pay back your subsidy. The way to avoid this – and get the most accurate tax credit amount – is to report income changes to the marketplace during the year as they happen, Kaiser Family Foundation advises. The marketplace will calculate enrollees’ household incomes using MAGI, which includes income sources such as wages, salary, foreign income, interest, dividends and Social Security. You can also check out KFF’s subsidy calculator here.





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