Group cites a 'historic opportunity' to insure

Much of the Affordable Care Act is slated to take effect in 2014, including a slew of health-insurance tax credits designed to offset costs of health-insurance premiums for individuals and families.

On Thursday, Families USA, a national consumer health organization, released a report that said more than 525,000 Missourians will be eligible for these premium tax credits -- to purchase from the new health insurance marketplace, also called an exchange. This exchange will be put in place to, in theory, make it easier for residents to find health coverage that meets their specific needs.

Those earning less than 138 percent of the poverty level would not be required to purchase from the exchange, because the Affordable Care Act calls for the expansion of Medicaid to cover those with the lowest income.

Ron Pollack, executive director for Families USA said it would be a "historic opportunity" to expand coverage for the currently uninsured.

"Those with annual incomes that are up to 400 percent of poverty, which equals about $94,200 for a family of four, are eligible for these tax credits," Pollack said. "This reaches very deeply into the middle class."

The size of an individual's or family's tax credit is based primarily on income. The amount is based on a sliding scale, where those with the lowest incomes pay the smallest proportion of income on their premiums, and established so premium spending does not exceed a specific percentage of income.

The idea is to provide health care to those who earn too much to be covered by Medicaid but not enough to afford private insurance -- a large number of people, according to Jen Bersdale, executive director for Missouri Health Care for All, a coalition dedicated to bringing affordable, quality health care to Missourians.

"We get calls and emails all the time from people making $30,000 a year that say they can't afford health care and can we help them," she said. "Before, we never really had a good resource to direct them to, but now we can tell them help is on the way."

It is working-class families who will make up the vast majority of those eligible for premium tax credits -- about 91 percent according to the Families USA report. This includes families with a worker employed either full or part time.

The report breaks the state into 23 regions, most made up of several counties. In the region made up of Bollinger, Cape Girardeau, Iron, Madison, Perry, St. Francis and Ste. Genevieve counties, the report says 53.1 percent of those eligible for the tax credits have an income between 200 and 399 percent of the federal poverty level. In the region, 90.9 percent of those eligible are employed.

When a person qualifies for a tax credit, the money flows directly into his or her selected insurance plan.

"The tax credits are fully advancable," Pollack said. "Meaning you don't have to put up the money first, then go to the IRS later and seek reimbursement."

The report also noted some families would be eligible for more financial assistance for co-payments, deductibles and other out-of-pocket costs.

For Patrick Ishmael, policy analyst at the Show-Me Institute, the Affordable Care Act and the premium tax credits will not make health care more affordable because they do not address the "cost problem."

"People fail to realize that the health-care market operates basically like no other market," Ishmael said. "In another market, we make the rational decision to save our money to spend on other things. There's no incentive to save health-care money, though. People have these premiums and, unfortunately, want to spend them until they're all used up."

Funneling government funds into these tax credits with the deficit at an all-time high also is a mistake, he said. The bill the country runs up today will become the responsibility of the young generation, Ishmael pointed out.

"Where's the money coming from? That's what I want to know," he said.

Despite his concerns over the Affordable Care Act, Ishmael said there was no doubt everyone, "whether right or left" would like to find a way to provide quality, affordable health care for everyone.

srinehart@semissourian.com

388-3641