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ObamaCare Clusterfuck: Kaiser explains to poor people in non-Medicaid expansion states how to game the system by lying

Kaiser Health News:

Some of the millions of poor people expected to lose out on Obamacare coverage next year because their states are not expanding Medicaid might have a way to get help, but the strategy carries risk.

Experts say the key is for them to project their 2014 income to at least the federal poverty level, about $11,500 per person or $23,500 for a family of four.

We explained how that works -- and the ethical problems with it -- here.

That would entitle them to federal subsidies that would cover nearly all the cost of private coverage sold on new online insurance marketplaces set up by the federal health law. The subsidies are available on a sliding scale to people making between the poverty level and four times that amount.

Everyone applying for subsidies must estimate their 2014 income. For the poor, the difference between qualifying -- or not -- could be $1,000 or less a year. Since many rely on hourly or seasonal work, their incomes often fluctuate by a few thousand dollars each year. That's one reason why people often lose eligibility for Medicaid, the state federal insurance program for the poor.

While there are steep fines for knowingly lying on a government application for financial assistance, if someone merely miscalculates their income above the poverty level in 2014, and is later found to have made less than the poverty level, they won't have to pay any money back, according to the Treasury Department.

"There's little risk because under the rules you don't have to pay anything back," said Richard Trembowicz, vice president for Celtic Insurance Co., a subsidiary of Centene Corp. which is offering plans on several exchanges, including Mississippi.

So, Kaiser is recommending that poor people "merely miscalculate" their income, just on the high side.

Maybe I'm just old-fashioned, but that sounds a lot like lying, to me. Will Kaiser also recommend that people "merely miscalculate" to avoid being forced into Medicaid? How about if they "merely miscalculate" a few dollars low to get into the Exchanges at 400% the poverty level, minus a dollar? Would that be OK? Why or why not?

To me, this is another example of how Obama corrupts whatever he touches. What's happened to Kaiser Health News -- a perfectly reputable organization -- that they're now going "nudge nudge wink wink" to poor people about how they can game the system?

Of course, and as usual, with single payer Medicare for all, none of this lying and gaming would be necessary: Everybody in, nobody out.

NOTE And how about the Navigators? Will they, too, recommend that people "merely miscalculate"?

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quixote's picture
Submitted by quixote on

Well, technically, technically, if your income could be anywhere between $10000 and $14000, and you get the best benefits at $11000, you're not literally lying if you estimate it at $11000.

Working the system doesn't have to be just for rich people, right?

Yes, it'd be a lot better if *nobody* did it and we had honesty. Maybe that's what the PTB hated so much about Medicare For All: no opportunities for playing games.

beowulf's picture
Submitted by beowulf on

Just think how nuts it is that you can be disqualified for making too little (1 dollar over FPL, full coverage, 1 dollar under FPL, you got nothing coming). Its criminal the Administration is going to let thousands if not millions of people go without healthcare simply because they didn't bother fixing this glitch with a countervailing glitch, namely, by phrasing income qualification thusly:
Do you earn more than FPL?
if they answer No, assume they earn precisely 100% FPL
if they answer Yes, only then ask,
How much more than FPL do you make?

Just by using imprecise language, all of those lucky duckies making under FPL could be covered without having to go back to Congress. The beauty of this is I don't think anyone would have legal standing to challenge this in court.