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Dania Palanker Senior Counsel March 24, 2014 THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE Advocating to Ensure Financial Assistance is Available

THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

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Page 1: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

Dania Palanker

Senior Counsel

March 24, 2014

THE HEALTH CARE LAW AND

SURVIVORS OF DOMESTIC

VIOLENCE

Advocating to Ensure Financial

Assistance is Available

Page 2: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

WHY THIS IS IMPORTANT

In 2008, one in four women reported going

without health care because they could not

afford it

Women make more than 80% of healthcare

decisions

Only 13% of plans sold in the individual market

included maternity

Women were charged more for health

insurance than men

Page 3: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have
Page 4: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

THE ACA: HELPING WOMEN

No pre-existing condition exclusions

Women can’t be charged more than men

Maternity benefits covered

Women’s preventive services covered without

cost-sharing

Bans sex discrimination in health care

New affordable health coverage options

Page 5: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

NEW HEALTH

MARKETPLACE

Page 6: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

New health insurance marketplace

No wrong door

Private insurance options

Financial assistance

Medicaid

CHIP

Individuals or small businesses

HEALTHCARE.GOV

Page 7: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

WHERE DID WOMEN GET THEIR HEALTH

COVERAGE IN 2011?

Source: National Women’s Law Center analysis of 2012 health insurance data from the U.S. Census Bureau Current

Population Survey’s (CPS) 2012 Annual Social and Economic (ASEC) Supplements

Medicaid ,

12.20%

Other

Public

Insurance,

5.80%

Employer

Sponsored

Insurance,

59.7%

Uninsured,

19.2%

Direct

Purchase,

8.0%

Target for new coverage options

Page 8: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

FINANCIAL ASSISTANCE (TAX CREDITS)

Premium Tax Credit

•Household income between 100 - 400% of poverty

•Reduces monthly premium

Cost Sharing Credit

•Household income between 100 – 250% of poverty

•Insurers change benefit design to reduce cost sharing

And there’s a small business tax credit too!

Page 9: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

REDUCED PREMIUMS AND COST

SHARING

Income $35,000 $30,000 $25,000 $20,000 $15,000

Monthly

Premium $225 $197 $132 $73 $13

Deductible $2,400 $2,400 $1,750 $400 $100

Out of Pocket

Maximum $6,350 $6,350 $3,500 $1,000 $500

Primary

Doctor Copay $40 $40 $40 $30 $10

Specialist

Copay $55 $55 $55 $40 $20

Generic

Prescription $20 $20 $20 $10 $5

Single Adult, Age 35 in Butler County, Alabama - Blue Value Silver Plan

Page 10: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

10

PLANS INCLUDE

Essential health benefits including: Maternity and newborn care

Mental health and substance use disorder services

Preventive services without cost sharing Contraception

Prenatal services, breast pumps, lactation counseling

Domestic violence screening

Cost sharing limits

Page 11: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

TIERS OF COVERAGE

Plans are in four tiers of coverage, based on the

percentage of costs they cover for the average person

60%

70%

80%

90%

Bronze

Silver

Gold

Platinum

Cost Sharing Reductions only

available in Silver Plans

Page 12: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

ENROLLMENT TIMELINE

• Ends March 31

• Last day to enroll in private insurance

Open Enrollment

• Opportunities for individuals to enroll due to a life event

• Marriage, divorce, birth or adoption of a child

• Losing other coverage

• Newly eligible for financial assistance or losing eligibility

Special Enrollments

• Can enroll any time

Medicaid and CHIP

A week from today!

Page 13: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

MANY WAYS TO ENROLL

Over the phone

Online at healthcare.gov

In person assistance with community organizations

Community heath centers and other providers

Libraries

Agents and brokers

Directly from an insurance company

Localhelp.healthcare.gov

Page 14: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

ENROLLMENT MAP

Apply through Marketplace

Medicaid or CHIP

Marketplace determines eligibility

Transferred to Medicaid

Coverage Gap

Advance Payment Premium Tax Credit

Review, Choose and Enroll

Pay Insurer

No Financial Assistance

Review, Choose and Enroll

Pay Insurer

Page 15: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

ENROLL AT HEALTHCARE.GOV

Page 16: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

FEDERALLY FACILITATED

Page 17: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

STATE BASED

Page 18: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

OPEN ENROLLMENT MAP

Apply through Marketplace

Medicaid or CHIP

Marketplace determines eligibility

Transferred to Medicaid

Advance Payment Premium Tax Credit

Review, Choose and Enroll

Pay Insurer

No Financial Assistance

Review, Choose and Enroll

Pay Insurer

Coverage Gap

Page 19: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

REVIEW PLANS ONLINE

Page 20: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

REVIEW PLANS ONLINE

Page 21: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

IT DOESN’T END AT ENROLLMENT

Page 22: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

OPEN ENROLLMENT MAP

Apply through Marketplace

Medicaid or CHIP

Marketplace determines eligibility

Transferred to Medicaid

Advance Payment Premium Tax Credit

Review, Choose and Enroll

Pay Insurer

No Financial Assistance

Review, Choose and Enroll

Pay Insurer

Coverage Gap Individuals under 100% of poverty

If state failed to expand Medicaid

Page 23: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

HELPING WOMEN IN THE

COVERAGE GAP

Page 24: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

Enroll children in Medicaid or CHIP

Inform about special enrollment periods

Change in marital status

Change in family size

Change in income

Connect to health services and providers

CONNECT AND INFORM

Page 25: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

Find a health center or clinic

findahealthcenter.hrsa.gov

http://www.plannedparenthood.org

http://www.nationalfamilyplanning.org (under contact)

National Breast and Cervical Cancer

Early Detection Program

1 (877) 252-3324

Prescription drug help

RxAssist.org

CONNECT TO RESOURCES

Page 26: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

SPECIAL ISSUES FOR

SURVIVORS OF

DOMESTIC VIOLENCE

Page 27: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

Exemption from requirement to maintain

health coverage

Simple application

Multiple categories of eligibility

http://marketplace.cms.gov/getofficialresource

s/publications-and-articles/hardship-

exemption.pdf

HARDSHIP EXEMPTIONS

Page 28: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

“You recently experienced domestic violence”

No documentation necessary

No definition of “recently”

Must provide explanation of how prevented

from getting health coverage

EXEMPTION FOR DOMESTIC VIOLENCE

Page 29: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

For anybody in the coverage gap

Must provide copy of notice of denial of

Medicaid coverage

Does not exempt from need to enroll children

eligible for Medicaid

EXEMPTION FOR COVERAGE GAP

Page 30: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

Survivors may experience qualifying life

events

Divorce or legal separation

Birth of a child

Change in eligibility for financial assistance

60 Days to enroll from the life event

Newborns can be enrolled retroactively to date of

birth

SPECIAL ENROLLMENT

Page 31: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

Married couples must file joint returns to be

eligible for financial assistance

Unless legally separated or divorced

Will have to repay if receive advanced credit

and then file separately

IRS may issue additional guidance or

regulations for special circumstances such as

domestic violence, but not yet

REQUIREMENT TO FILE JOINT RETURN

Page 32: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

May not be considered married under the tax

code if

Have a dependent child living with you for at

least six months of the tax year,

Furnish over half of the cost of maintaining

the household, and

Spouse is not a member of household for last

6 months of tax year

If you meet these requirements, you can file as

head of household and not as married.

ONE EXEMPTION TO TAX DEFINITION OF

MARRIED

Page 33: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

We need your help to get an allowance for

survivors of domestic violence to file separate

tax returns from their spouse

Share your stories and experience by adding

them to our template letter

Send the letter to IRS and Treasury

HELP US CHANGE REGULATIONS FOR

SURVIVORS OF DOMESTIC VIOLENCE

Page 34: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

?

QUESTIONS

Page 35: THE HEALTH CARE LAW AND SURVIVORS OF DOMESTIC VIOLENCE · domestic violence, but not yet REQUIREMENT TO FILE JOINT RETURN May not be considered married under the tax code if Have

Dania Palanker

Senior Counsel

[email protected]

NWLC.org


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