How Health Reform would affect

The Greens: no employer coverage, family on Medicaid

The Greens: no employer coverage, family on Medicaid

Leonard, 31, works for small contractor that doesn’t offer insurance to employees. Wife Angela, 29, stays at home with their two kids. Income: $32,000. They live in one of 12 states (plus DC) that offers Medicaid to both children and parents at this income level.

Under the Proposed Health Reform Bills:

CHOICES

  • The Green's Medicaid health coverage would continue. At least until 2013 (depends on the proposal), states would be required to maintain programs like this that are already in place.
  • Or, Len's employer could begin to offer coverage, because the firm may qualify for new tax credits that help small businesses to help pay the cost of coverage.
  • Depending on the proposal, Len's family may be able to get affordable coverage through the new health insurance exchange featuring a variety of health insurance chocies.

COSTS

  • The Green’s cost for Medicaid coverage will likely continue to have low premiums or non-existent premiums.
  • Depending on the proposal, Len may be able to get premium credits to pay for coverage through the new health insurance exchange.
  • If Len’s employer decides to offer coverage, Len’s cost could be as high as 35% to 40% of the premium, depending on how much his employer decides to contribute. Len isn’t required to enroll – he can keep his Medicaid coverage if that’s better for his family.

DIFFERENCES

House bill (H.R. 3962, passed November 7, 2009):

  • Medicaid eligibility rises to 150% of Federal Poverty Level (FPL), for all legal residents including childless adults. States that currently maintain higher thresholds must continue to do so.
  • Medicaid-eligible individuals do not qualify for premium credits to purchase in the exchange.

Senate Bill (H.R. 3590, H.R. 3590, passed December 24, 2009):

  • Medicaid eligibility rises to 133% of Federal Poverty Level for all legal residents, including childless adults. States that currently maintain a higher threshold for children must continue to do so until 2019. States that currently maintain higher eligibility thresholds for adults must continue to do so until the exchanges are operational in 2014.Exception: states with budget deficits can roll back coverage levels if above 133% FPL.
  • After the exchanges open in 2014, Medicaid-eligible adults with incomes higher than 133% of FPL (like the Greens) may be able to purchase in the exchange, depending on whether their state rolls back the eligibility threshold for this coverage to the new national standard.

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