Affordable Care Act Deadline Looms for Uninsured

By Ruojing Liu

As the deadline for applying for health insurance through the Affordable Care Act open enrollment draws near, punishment for the uninsured is also getting real.

At a press conference Tuesday at John H. Stroger, Jr. Hospital, officials from the federal to the city level urged local uninsured residents to get a health plan before the January 31 health insurance Marketplace open enrollment deadline and avoid financial penalty.

“The ability to have insurance gives you the ability to change the currency that you’re using to pay for your care,” said Dr. Jay Shannon, CEO of Cook County Health and Hospitals System (CCHHS). “You get insurance to pay for your care, instead of what low-income people have always paid with in this country, and that is their time, their dignity and their self-respect.”

This year, not having minimum essential coverage is not just about not having access to primary care doctors. Those who can afford to purchase health insurance but choose not to will face a fine of $695 per adult and $347.50 per child under 18, or 2.5 percent of the household income above the yearly tax filing threshold ($10,150 for individuals or $20,300 for couples filing jointly in 2015), whichever is higher. The maximum fine is $2,085. The maximum and per person fines more than doubled from last year.

For example, a household of two adults and two children with an income of $70,000 will pay a fine of $2,085 for 2016.

If the minimum annual premiums – the fees paid to purchase the insurance – is more than 8 percent of your household income, you are qualified for an exemption from the requirement to maintain qualified healthcare coverage.

Although there are no levies or criminal penalties for failing to pay the fee, the money will be taken from federal tax refund by the Internal Revenue Service.

Marketplace is offering different subsidies for people who need financial support. For example, any household of four in Illinois with an estimated 2016 income of $97,000 or less would be eligible for some kind of savings based on income alone.

According to the U.S. Department of Health and Human Services (HHS), more than half of Illinois enrollees are eligible for plans costing $75 or even less a month in premiums after tax credits. In the first two months of this year’s open enrollment period, three out of four of those who enrolled in Illinois received financial support and saved an average of $236 per month after tax credits, said Kathleen Falk, U.S. HHS Regional Director.

Compared to the $695 fine, the possible annual premium of $900 based on the above $75 monthly premium is still much higher, and officials fear it might cause some people to choose to pay the fine instead of getting health coverage

According to statistics published by the White House, by the end of last June, 297,406 people in Illinois were covered through Marketplace. Among 354,962 Illinois residents currently enrolled through Marketplace, 283,454 are in the greater Chicago and Cook County area. On the national level, about 8.7 million people signed up for health coverage through the platform.

CCHHS is also seeing less uninsured patients since the Affordable Care Act became law. The percentage of uninsured patients CCHHS cares for has dropped from 54 percent in 2013 to 32 percent in 2015, while the money CCHHS spent to compensate for those who are uninsured or unable to pay medical bills was $500 million in 2013, but dropped to $342 million in 2014.

A recent ranking from the White House said Chicago ranked second in a competition to decrease uninsured rate among 20 key communities with large numbers or high percentages of uninsured across the country. Milwaukee currently ranked first within this “Healthy Communities Challenge” initiated by the White House last November.

Brian Gorman, director of outreach and consumer education at Get Covered Illinois, said about half of those uninsured are 18 to 34 years old, encouraging young people to take the opportunity.

“Between Medicaid expansion and Marketplace plans, we’re providing people with the dignity of coverage and the services they need to improve and maintain their health,” said Toni Preckwinkle, Cook County Board President. “I urge everyone who is not covered presently to find a plan that suits their need and get covered.”

Julie Morita, M.D., Chicago Department of Public Health Commissioner, shares her personal experience to encourage local residents to get insured within the deadline. (Ruojing Liu/MEDILL)