ObamaCare Clusterfuck: Ask a simple question, get a complicated answer
Kaiser's Michelle Andrews takes questions. I'm just going to quote the Q&A in its entirety:
Q. I expect the annual premium for my company's group plan to be about $24,000, or 50 percent of my family's income. Will my family be eligible for subsidized coverage on the state insurance exchanges in 2014, provided we meet the poverty-level requirements?
A. It depends. Under the Affordable Care Act, companies with 50 or more workers must offer health insurance coverage that is both affordable and adequate; otherwise, their workers may be eligible for subsidized coverage on the online health insurance exchanges if their income is less than 400 percent of the federal poverty level ($94,200 for a family of four in 2013).
A plan is considered adequate if it covers at least 60 percent of an employee's covered medical expenses and affordable if the cost for employee-only coverage doesn't exceed 9.5 percent of a worker's income.
Some consumer advocates argued that the 9.5 percent test should also apply to the cost of family coverage, which is generally much more expensive than employee-only coverage. But in a final rule issued in February, the Internal Revenue Service said that it would not consider the premium for family coverage in determining affordability.
If the premium for employee-only coverage at your company is less than 9.5 percent of your income, your family may be out of luck.
"The whole family could be barred from premium tax credits on the exchange," says Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities. Depending on family income and size, however, the kids could be eligible for coverage under their state's Medicaid or CHIP program, Park says.
Coulda, woulda, shoulda....
NOTE Of course, with single payer Medicare for All, there is a very simple, one word answer: Yes.