Report estimates NC, local residents eligible for 2014 health insurance subsidies

Apr. 05, 2013 @ 06:28 PM

Carrboro resident Jeremy Gilchrist said he believes can’t afford to pay health insurance premiums now, and he said he wasn’t aware until recently that a federal tax credit would be available to help some people with that cost next year.

Gilchrist, 36, said he makes about $20,000 per year as a contract meteorologist. He said he doesn’t know how much of a subsidy he might be eligible for, but he’ll likely buy if he thinks insurance is affordable with a subsidy.

“As far as it all goes, I’m hopeful that it will help me out in some degree so I don’t have to have so much anxiety in case something happens,” he said.

The federal health care overhaul requires U.S. citizens and legal residents to have qualifying health coverage starting next year, or face a tax penalty, with some exceptions, according to information from the Henry J. Kaiser Family Foundation website.

Tax credits are slated to help people buy private health insurance through health insurance exchanges next year, according to the Washington D.C-based health care consumer advocacy group Families USA.

According to the group, the tax credits will take effect in January 2014 following an enrollment process that will begin in October.

Generally, individuals in families above 100 percent of the federal poverty level and up to 400 percent are eligible for the subsidies.

That’s if they’re not also eligible for Medicaid, Medicare or TRICARE, which is the federal health care program for members of the military, their families and retirees, or if they don’t already have insurance offered by their employers that’s considered affordable, according to information from Families USA.

The group released a report on Wednesday that estimates the number of people expected to be eligible for tax credits in North Carolina. However, Kathleen Stoll, director of health policy for Families USA, said the report’s estimates are low for North Carolina because the report assumes the state opted to expand the Medicaid program, which was an optional provision of the health care overhaul.

The expansion would have increased Medicaid eligibility for people up to 138 percent of the federal poverty limit. Gov. Pat McCrory signed a bill blocking the expansion in North Carolina. The bill also blocked the set-up of a state-run health insurance exchange here, so a federally run exchange will be set up.

Stoll said that because the report assumes the Medicaid expansion would take place, it excludes people who could be eligible for premium tax credits between 100 and 138 percent of the federal poverty limit.

“(The) law says that premium tax credits are available to people down to 100 percent if they are uninsured or if they are not eligible for Medicaid, and they don’t have an affordable offer (from their employer),” Stoll said. “It’s down to 100 percent if you’re not eligible for Medicaid.”

The report by The Lewin Group, and commissioned by Families USA, expects 23,280 people in Durham County to be eligible for premium tax credits to help pay for health insurance next year.

In Orange and Chatham counties, the number is 15,220, according to the report. Across the state, 868,520 North Carolinians are expected to be eligible for tax credits in the first year of the operation of the exchanges, the report states.

The amount of the tax credits will be determined based on a sliding scale based on income, according to Families USA.

Gilchrist said he wanted to see more public information available.

“I think it would be good if they had some kind of public seminars where they can expand to people that haven’t looked into what’s coming and what they can do,” he said.

Stoll said that if the state had opted to run its own exchange, there wouldn’t necessarily be more resources for outreach regarding the health care overhaul. She said that the state might have been more active in promoting it, however.

She said there will be an opportunity for state with federal exchanges to request resources to help pay for outreach resources.

“The funding opportunity announcement should be announced any day,” she said.