Poor Can Get Subsidies Without Medicaid Expansion, Experts Say

Low-income people in states that opt not to expand Medicaid under the Patient Protection and Affordable Care Act can still get financial assistance with coverage, although the strategy could prove risky, experts say, according to a Kaiser Health News report.

Individuals and families can get federal subsidies to cover nearly all of the cost of private insurance coverage by projecting their 2014 income to at least the federal poverty level — $11,500 per person or $23,500 for a family of four, according to the report. The subsidies are available under the PPACA on a sliding scale for those making between the poverty level and four times that level of income.

However, some consumer advocates have said they wouldn't encourage people to do anything that might seem like defrauding the government. In applying for subsidies, the health insurance exchanges will require more information if a person projects an income of more than 10 percent higher than shown in electronically available data such as a tax return. If the person applying can't provide more information such as a pay stub, however, the exchanges will rely on their self-attestation, according to the report.

Although individuals who lie on a government application for financial assistance face considerable fines, those who miscalculate their incomes above the poverty level for 2014 and are later found to make less than the poverty level won't have to pay back their subsidies, according to the report.

The PPACA originally required all states to extend Medicaid to cover everyone under 138 percent of the federal poverty level. However, the Supreme Court ruled last year to make the program expansion optional.

More Articles on Medicaid Expansion:
Sebelius Open to Unique Texas Insurance Expansion
5 Considerations for Hospitals Prepping for the Newly Insured
Auditor: Kentucky Needs More Resources to Handle Medicaid Expansion

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