Las Vegas Sun

March 24, 2018

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Did you miss the ACA deadline? Don’t panic


Yasmina Chavez

Heather Korbulic, executive director of the Silver State Health Insurance Exchange, is shown during an interview at the Las Vegas Sun office, Thursday, Oct. 2, 2017.

Individual mandate fees are still in place this tax season

While the recently approved Republican tax overhaul will eliminate Obama-care’s individual mandate for health insurance by 2019, fees for not having health insurance will remain for 2017 and 2018.

Uninsured Nevadans will owe either 2.5 percent of their household income, $695 per adult or $347.50 per child — whichever is higher — on their federal income tax returns. This fee is called the “Shared Responsibility Payment” by the IRS. It rises with inflation, according to Heather Korbulic, CEO of the Silver State Health Insurance Exchange, and amounts in 2018 could be higher.

Those who were uncovered for just some months of the year owe $57.92 for each month they did not have health insurance.

Nevadans whose health care isn’t covered by their employers and who missed the Dec. 15 deadline for government-provided insurance still have options for the coming year, according to local experts.

Apart from the extended deadline (see below) for the Affordable Care Act, also known as Obamacare, several other options exist for both short- and long-term health care plans.

“There are, in fact, options off-exchange,” Korbulic said. “But now it’s up to people to find federally qualified health centers across the state that can help them find an opportunity.”

UNLV professor Christopher Cochran echoed that thought, adding that unless a person qualifies for an extended deadline for Obamacare, a local health care company like Blue Cross Blue Shield or UnitedHealthcare would be the next best option for insurance next year.

“If a person doesn’t qualify for the subsidies and it’s past open enrollment, they may have a problem unless a broker can negotiate something for them,” Cochran said. “Income is going to have a lot to do with what the insurance companies are looking for.”

As many as 2.5 million of Nevada’s more than 3 million residents were eligible for financial assistance on government-provided health care insurance — between Obamacare subsidies, Medicaid and Medicare — though many were covered by employer-based plans.

Both Korbulic, who leads Nevada’s organization connecting to federal health care, and Cochran, who chairs UNLV’s department of health care administration and policy, emphasized the importance of finding a plan not only to avoid tax penalties of at least $695, but to avoid the risk of not being covered in the event of sickness or injury.

With uninsured patients paying “multiple times” the cost of care to hospitals as those with insurance plans, purchasing health insurance “just makes sense,” Korbulic said.

“It’s about the financial risk you put yourself or your family in if you don’t have insurance and you end up having an illness or any kind of medical event,” she said.

The experts added that while a sweeping tax overhaul passed by Congress will affect the future of Obamacare, most health care provisions — including the elimination of the individual mandate, which charges uninsured Americans the tax penalty — won’t kick in until 2019.

Do you qualify for both Medicare and Medicaid?

Dual Eligible Special Needs Plans:

Thanks to a provision of the ACA, Nevadans entitled to both Medicare and Medicaid can combine their benefits using the two as a pseudo insurance package by a single managed care organization. Korbulic recommended taking that route for those who missed the Dec. 15 ACA deadline and don’t qualify for a special exemption.

Unlike Obamacare insurance, Medicaid has open enrollment year-round, meaning qualified Nevadans who enroll in the program can obtain a Dual Eligible Special Needs plan through the end of January without facing retribution on next year’s taxes.

Korbulic said Nevadans can check whether they qualify for the Special Enrollment Period and potential Dual Eligible Special Needs Plans on the Silver State Health Insurance Exchange’s website:

Have you had a recent major life change?

Special Enrollment Period:

Nevadans with extenuating circumstances, known officially as Qualifying Life Events, will be eligible for a special enrollment period, which for some QLEs extends through as late as March 1.

Circumstances and life changes that would still qualify Silver State residents for government-provided health care in 2018 past the Dec. 15 deadline include:

• Recent marriage or divorce

• Birth or adopting a child; also placing a child up for adoption

• Change in income

• Change in residence

• Change in disability status

• Addition or loss of a dependent person

• Pregnancy

• Other changes in income or household size

• Change of citizenship or immigration status

• Incarceration or release from incarceration

• Change in status as an American Indian/Alaska Native or tribal status