What Obamacare means for thousands of Kenyans in the US

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The deadline to enroll in the US federally mandated Patient Protection and Affordable Care Act (PPACA) which is popularly known as Obamacare is fast approaching.

March 31, 2014 is the last day for signing up for the federal Statute signed into law by President Barack Obama on March 23, 2010.

But even as the clock ticks, questions abound as to who exactly qualifies to purchase the health insurance under the law and what benefits come with it.

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Like millions of other immigrants domiciled in the United States, many Kenyans residing here have found this legislation rather confusing, leaving them with more questions than answers.

They wonder, for instance, what would happen to them if they do not enlist. Others mull over whether undocumented workers would benefit and if not, what will happen to them if they are taken ill.
Let us start with the basics: At midnight on Monday, individuals and families who will have purchased health insurance on their own would be able use the new premium tax credit to help them afford coverage purchased through a state exchange or the federal exchange.

These sliding-scale credits will only be available to those who are not eligible for affordable coverage from other sources and whose incomes fall within two to four times the federal poverty level.

Consequently, undocumented immigrants living in the United States are expected to become the largest segment of the population without health insurance. It has been estimated that as much as half of the illegal immigrant population in the United States don’t have health insurance.

So who is really eligible for this programme?

The relevant section of the law lies in Section 1312 (f)(3), which reads: “Access is limited to lawful residents. If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.”

In essence, the clause shuts out millions of individuals from the federally mandated programme. Put bluntly, the law does not grant undocumented, or illegal immigrants access to taxpayer-funded subsidies or credits to buy health insurance through exchanges.

But all is not lost. Federal law bequeaths every individual the right to emergency medical care. This means that regardless of your immigration status, you cannot be turned away at the emergency desk of any hospital even if you are from Mars, as it were. Besides, since these individuals are not subject to the individual mandate, they shall not be subject to any penalties for being uninsured.

So what happens if those qualified but fail to register by March 31?

If you miss the open enrollment, you will have to wait until 2015 to buy an individual medical plan for essential coverage. This applies to plans sold on and off the state-based and federal facilitated health insurance exchanges. You will be subject to what has come to be known as shared responsibility payment when filing the 2014 taxes.
However, if you have a qualifying life event such as getting married, losing coverage due to situations such as divorce or job loss, relocation to an area with different health plans, having a baby or adopting a child, you have access to a special enrollment period. In most cases, special enrollment lasts 60 days from the qualifying life event.

President Obama has severally said that an estimated 26 million Americans will be eligible for these credits.

What then happens to those who deliberately miss the enrollment deadline?

For the most part, those who decide not to purchase health insurance coverage can opt-out of the Exchange by paying a penalty. For this year, the fine would be $95 per adult or one per cent of your annual income, whichever is greater. The penalty will increase over time; next year, it will be $325 for an adult or two per cent of your yearly income.

Exemptions apply to certain populations, such as those with brief coverage gaps, those who cannot afford coverage, members of marginalised groups and members of federally recognised religious groups which object to certain benefits. The amount will increase annually.

The Obama administration has launched a Health Care Reform Calculator to help individuals and families determine how the requirement to buy health insurance coverage will specifically impact them. Simply enter your age, state, income and any additional family members’ ages to determine what you can expect to pay for a Bronze, Silver, Gold or Platinum plan through the exchanges. The cost with and without the tax credit is calculated. You can also learn what your opt-out penalty will be should you choose to go without qualified health insurance coverage. Small business owners who offer health insurance to their employees may also use this calculator to determine costs.

On Saturday, Reuters reported that more than 6 million people had signed up for the private insurance plans. The surge in enrollments just two days before the March 31 deadline is a milestone which gives President Obama some ammunition to counter Republican critics, who have described the programme as “an expensive flop.” Initially, Obama’s administration had estimated that about five million people would have enrolled by the deadline.-

The deadline to enroll in the US federally mandated Patient Protection and Affordable Care Act (PPACA) which is popularly known as Obamacare is fast approaching.

March 31, 2014 is the last day for signing up for the federal Statute signed into law by President Barack Obama on March 23, 2010.

But even as the clock ticks, questions abound as to who exactly qualifies to purchase the health insurance under the law and what benefits come with it.

Like millions of other immigrants domiciled in the United States, many Kenyans residing here have found this legislation rather confusing, leaving them with more questions than answers.

They wonder, for instance, what would happen to them if they do not enlist. Others mull over whether undocumented workers would benefit and if not, what will happen to them if they are taken ill.
Let us start with the basics: At midnight on Monday, individuals and families who will have purchased health insurance on their own would be able use the new premium tax credit to help them afford coverage purchased through a state exchange or the federal exchange.

These sliding-scale credits will only be available to those who are not eligible for affordable coverage from other sources and whose incomes fall within two to four times the federal poverty level.

Consequently, undocumented immigrants living in the United States are expected to become the largest segment of the population without health insurance. It has been estimated that as much as half of the illegal immigrant population in the United States don’t have health insurance.

So who is really eligible for this programme?

The relevant section of the law lies in Section 1312 (f)(3), which reads: “Access is limited to lawful residents. If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.”

In essence, the clause shuts out millions of individuals from the federally mandated programme. Put bluntly, the law does not grant undocumented, or illegal immigrants access to taxpayer-funded subsidies or credits to buy health insurance through exchanges.

But all is not lost. Federal law bequeaths every individual the right to emergency medical care. This means that regardless of your immigration status, you cannot be turned away at the emergency desk of any hospital even if you are from Mars, as it were. Besides, since these individuals are not subject to the individual mandate, they shall not be subject to any penalties for being uninsured.

So what happens if those qualified but fail to register by March 31?

If you miss the open enrollment, you will have to wait until 2015 to buy an individual medical plan for essential coverage. This applies to plans sold on and off the state-based and federal facilitated health insurance exchanges. You will be subject to what has come to be known as shared responsibility payment when filing the 2014 taxes.
However, if you have a qualifying life event such as getting married, losing coverage due to situations such as divorce or job loss, relocation to an area with different health plans, having a baby or adopting a child, you have access to a special enrollment period. In most cases, special enrollment lasts 60 days from the qualifying life event.

President Obama has severally said that an estimated 26 million Americans will be eligible for these credits.

What then happens to those who deliberately miss the enrollment deadline?

For the most part, those who decide not to purchase health insurance coverage can opt-out of the Exchange by paying a penalty. For this year, the fine would be $95 per adult or one per cent of your annual income, whichever is greater. The penalty will increase over time; next year, it will be $325 for an adult or two per cent of your yearly income.

Exemptions apply to certain populations, such as those with brief coverage gaps, those who cannot afford coverage, members of marginalised groups and members of federally recognised religious groups which object to certain benefits. The amount will increase annually.

The Obama administration has launched a Health Care Reform Calculator to help individuals and families determine how the requirement to buy health insurance coverage will specifically impact them. Simply enter your age, state, income and any additional family members’ ages to determine what you can expect to pay for a Bronze, Silver, Gold or Platinum plan through the exchanges. The cost with and without the tax credit is calculated. You can also learn what your opt-out penalty will be should you choose to go without qualified health insurance coverage. Small business owners who offer health insurance to their employees may also use this calculator to determine costs.

On Saturday, Reuters reported that more than 6 million people had signed up for the private insurance plans. The surge in enrollments just two days before the March 31 deadline is a milestone which gives President Obama some ammunition to counter Republican critics, who have described the programme as “an expensive flop.” Initially, Obama’s administration had estimated that about five million people would have enrolled by the deadline.

nation.co.ke

Former Prime Minister Raila Odinga with the Kenyan Diaspora in Boston Massachusetts on March 21, 2014. Like millions of other immigrants domiciled in the United States, many Kenyans residing here have found the new healthcare legislation rather confusing, leaving them with more questions than answers.

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