For one Allen County woman John Robertson is as much a knight in shining armor as was Sir Galahad. I DOUBT the woman’s situation differs much from many others in Allen County.
Robertson, under auspices of Thrive Allen County, works as a navigator to help people obtain health insurance coverage through the Affordable Care Act Marketplace
The woman, who prefers not to be identified, retired not long ago with every intention of living quietly in her little corner of the world. She qualified for a Social Security allotment of about $900 a month. That’s not a great deal but with no debt and no dependents, she figured it would be sufficient.
The catch arose when she went shopping for health insurance, which previously had been a perk of her employment. The best she could do on the private market was a policy with monthly premiums of $540, which ate up 60 percent of her monthly Social Security payment.
She was forced to cash in a modest IRA in January to make her new insurance payments. It will be another two years before she qualifies for Medicare.
Because Kansas has not expanded its Medicaid guidelines, the woman is caught in what is called the Medicaid Gap.
Her current income of $10,800 is below the federal poverty level of $11,700 for an individual, the benchmark that qualifies individuals to receive tax credits to help pay for health insurance under the new ACA.
The thinking on the federal government’s part was that for those who live on less than the federal poverty guideline, their states would enroll them into their Medicaid programs, which the feds have agreed to help pay for an expanded program.
Kansas’ current Medicaid program is especially restrictive because its benefits apply only to those who have a disability, are pregnant, or who have dependants.
For this single woman, no matter how destitute, she would never qualify for Medicaid benefits.
If Kansas were to expand Medicaid, those restrictions would no longer apply. The only consideration for benefits would be one’s income.
The woman, thus, was forced into a terrible situation.
This is where Robertson’s magic came into play.
“Let’s see what we can do,” he said, when the distressed woman came to his office Wednesday evening.
Seems the money being withdrawn from her IRA policy can be considered taxable income and when added to her Social Security income nudges her up to the federal poverty level. She now qualifies for tax credits under the Affordable Care Act.
Her new premium is $110 a month. Remember, it was $540, and without the Affordable Care Act would have remained at that level.
The new plan also includes dental insurance and deductibles as good or better than she had before.
ACA enrollment remains open through the end of March. Take advantage. You may be just as ecstatic with the results as this woman was.
— Bob Johnson
ACA health plan a lifesaver for local
