An estimated 40,840 Clark County residents will be eligible for help paying for insurance coverage under the 2010 Affordable Care Act — and most of them don't know it, according to a health-reform advocacy group.
Families USA released a report this week that estimates that nearly 598,000 Washingtonians will be eligible for the new premium tax credits in 2014. The vast majority — 88 percent — of those eligible for the credits will be in working families, according to the report.
The health care act not only extends Medicaid coverage for the low-income uninsured, it also provides subsidies to those with incomes as high as 400 percent of the federal pov
erty level. That's $46,000 for an individual and $94,200 for a family of four.
"This reaches deeply into the middle class," said Ron Pollack, executive director of Families USA. "The tax credit subsidies are a game-changer: They will make health coverage affordable for huge numbers of uninsured families who would have been priced out of the health coverage and care they need."
But those eligible for the subsidy won't receive it automatically. They have to apply.
"The overwhelming majority of people who are uninsured today who will be eligible for these premium subsidies aren't aware of it," Pollack said in a teleconference. "That's why it's so important that people learn about it."
The Washington State Office of the Insurance Commissioner is already preparing for enrollment, which begins Oct. 1 and ends March 31. In subsequent years, the enrollment window will be shorter.
The state insurance commissioner is reviewing insurance companies' plans to make sure they cover essential services, said Stephanie Marquis, a spokeswoman for the office. In a few weeks, the office will begin reviewing proposed rates for the plans, she said.
Once the plans and rates are approved, then they can be included in the Washington Health Benefits Exchange, which already has a website. Consumers will be able to use Washington Healthplanfinder to apply for coverage as well as subsidies, said exchange spokesman Michael Marchand.
The Affordable Care Act extends Medicaid coverage to those with incomes at 138 percent of the federal poverty level. The state Legislature is expected to accept federal money to expand coverage.
The subsidies for families above the Medicaid cutoff will be offered on a sliding scale. A single person making $23,000 a year might receive $3,550 toward a $5,000-a-year policy, leaving only $121 a month to pay out-of-pocket for premiums, according to an example in Family USA's report, "Help Is at Hand: New Health Insurance Tax Credits in Washington." A family of four with an income of $35,300 would pay about $118 a month for a $12,500 plan, with the remainder covered by the subsidy.
The credits will be paid directly to the insurance company. This lowers families' bills, and also prevents the cash-flow problems that would occur if families had to wait until they received a year-end tax refund.
"These tax credit premium subsidies are not tiny matters," Pollack said. "They are very significant."