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Varying health premium subsidies worry consumers

KELLI KENNEDY
Associated Press

MIAMI (AP) — Linda Close was grateful to learn she qualified for a sizable subsidy to help pay for her health insurance under the new federal law. But in the process of signing up for a plan, Close said her HealthCare.gov account showed several different subsidy amounts, varying as much as $180 per month.

Close, a South Florida retail worker in her 60’s, said she got different amounts even though the personal information she entered remained the same. The Associated Press has reviewed Close’s various subsidy amounts and dates to verify the information, but she asked that her financial information and medical history not be published for privacy reasons.

“I am the kind of person the Affordable Care Act was written for: older, with a pre-existing (condition) and my previous plan was being cancelled. I need it and I’m low income,” said Close, who has spent more than six months appealing her case. “The government pledged to me that original tax credit amount. It’s crazy.”

Government officials say Close — and other consumers who have received different subsidy amounts — probably made some mistake entering personal details such as income, age and even ZIP codes. The Associated Press interviewed insurance agents, health counselors and attorneys around the country who said they received varying subsidy amounts for the same consumers. As consumers wait for a resolution, some have decided to go without health insurance because of the uncertainty while others who went ahead with policies purchased through the exchanges worry they are going to owe the government money next tax season.

These difficulties faced by Close and others are unfolding separately from the legal battle that flared this week when two federal appeals courts issued contradictory rulings on the subsidies in states that rely on the federal health exchange. The Obama administration says policyholders will keep getting financial aid as it sorts out the legal implications.

The government said consumers who received multiple subsidy estimates or disagree with their subsidy amount can appeal. The government hopes to resolve most of the appeals paperwork this summer. It’s unclear how many people received or appealed varying subsidy amounts.

Still, Centers for Medicare and Medicaid Services spokesman Aaron Albright said consumers “should feel confident that they received an accurate determination based on the information they provided in their application.”

Federal health officials ruled on Close’s appeal last month, giving her yet another subsidy estimate, which was within a few dollars of the one she is currently receiving, her attorney said.

Subsidies are important to making premiums under the new health care law affordable. About 87 percent of the more than 8 million people who signed up for coverage under the law received subsidies, which are paid directly to the insurance company on behalf of individual consumers, according to data from federal health officials. Consumers pay the difference directly to the insurance company each month just as they do with private insurance.

Dallas insurance agent Jo Ann Charron said the different estimates her clients received varied as much as $100 a month.

“Some of them got more of a subsidy, some of them got less,” she said.

Since consumers aren’t required to use the entire amount, Charron said she encouraged her clients to accept at least $50 less than the highest subsidy quoted to give them a financial cushion in case the government ultimately decides that the lower amount applies.

The differing subsidy calculations are part of a mountain of data conflicts affecting at least 2 million people who signed up for coverage in the new health insurance exchanges. Most of the discrepancies involve important details about income, citizenship and immigration status — which affect eligibility and subsidies.

Some supporters of the law fear low-income consumers will owe the government money because their subsidy was incorrect. Federal health officials have repeatedly stated that the IRS will have the final say, regardless of what figures were generated on healthcare.gov. The IRS can deduct the amount from consumers’ tax refund or tell consumers they owe the government money. Or, conversely, consumers could receive money back if they took too low of a subsidy.

The government says the varying subsidy amounts likely were generated several ways: As consumers struggled to navigate the glitch-plagued healthcare.gov website, they often had to start new applications and unknowingly might have entered slight differences in their income, ZIP code or number of dependents. In some cases, consumers completed an application and received a subsidy they thought was incorrect and then called the hotline or had a navigator or insurance agent fill out another application. The applications likely contained some small differences, which generated another subsidy figure.

Many consumers were required to submit additional paperwork to complete their applications, including citizenship or tax information, and that additional information also could have generated a different subsidy amount.

In Roanoke, Virginia, insurance agent Carol Taylor had seven clients who remain uninsured because of unresolved subsidy questions after federal officials asked them to submit additional documents to verify their income.

“They are just sitting there. They haven’t picked (a plan) because they can’t get a correct answer, and they’d rather wait until they get through the verification process to make sure they get the right amount,” Taylor said.

Although the enrollment deadline has passed, federal officials can grant consumers special status that would allow them to pick a plan now.

About half of the two dozen consumers Taylor helped enroll in the marketplace had problems with eligibility results. She spent hours on hold with the federal government trying to resolve the issue for five clients and was told consumers should go with the lower subsidy amount to avoid having to repay any money later in case of an error.

Delaware insurance agent Nick Moriello’s client was quoted an $87 subsidy from healthcare.gov and a roughly $30 subsidy from the federal government’s hotline. In the meantime, his client isn’t buying a plan.

“She said if I’m only going to be eligible for the $30 credit, it’s not going to be affordable for me so I’ll wait,” he said.

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Follow Kelli Kennedy on Twitter at www.twitter.com/kkennedyAP

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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