Are ACA-compliant plans sold outside the exchanges eligible for subsidies eventually?

My understanding has long been that one has to buy their plan on the appropriate government exchange (healthcare.gov for most states, or the state exchange for states that set up their own state exchange) in order to qualify for the premium subsidy and the out-of-pocket costs subsidy.

(By way of background, I'm in Minnesota, which has a state ACA health insurance exchange called MNSURE at MNSURE.org (don't ask me why its not MNSURE.gov) )

Now I'm being led to believe by a HealthPartners salesperson that all ACA-compliant plans, whether or not they are available on the appropriate exchange, is eligible for the subsidy.

He says (if I understood correctly):

(a) That those who buy their plan on the government exchange get immediate relief -- their monthly premiums are reduced by the subsidy. (I know that to be a fact because early last year I bought such a plan on MNSURE, and my monthly premiums are reduced by the subsidy)

(b) That those who buy an ACA compliant plan outside of the exchange also are eligible for the subsidy, but must wait until they file their tax return in order to get the subsidy (e.g. as a result of filing 2015 taxes in say March 2016, I will get whatever subsidy I'm entitled to for 2015 in the form of a refund (or reduction in taxes owed)). This statement I doubt.

(c) All HealthPartners individual plans -- not just the ones available on the government exchange (in my case, Minnesota, the MNSure state exchange) -- are ACA compliant. That agrees with a HealthPartners brochure that says:

"Key plans meet all of the requirements of the Affordable Care Act. In fact, all HealthPartners individual plans meet the standards so you don’t have to worry!"

Are ACA-compliant plans sold outside the exchanges eligible for subsidies eventually?

My understanding has long been that one has to buy their plan on the appropriate government exchange (healthcare.gov for most states, or the state exchange for states that set up their own state exchange) in order to qualify for the premium subsidy and the out-of-pocket costs subsidy.

(By way of background, I'm in Minnesota, which has a state ACA health insurance exchange called MNSURE at MNSURE.org (don't ask me why its not MNSURE.gov) )

Now I'm being led to believe by a HealthPartners salesperson that all ACA-compliant plans, whether or not they are available on the appropriate exchange, is eligible for the subsidy.

He says (if I understood correctly):

(a) That those who buy their plan on the government exchange get immediate relief -- their monthly premiums are reduced by the subsidy. (I know that to be a fact because early last year I bought such a plan on MNSURE, and my monthly premiums are reduced by the subsidy)

(b) That those who buy an ACA compliant plan outside of the exchange also are eligible for the subsidy, but must wait until they file their tax return in order to get the subsidy (e.g. as a result of filing 2015 taxes in say March 2016, I will get whatever subsidy I'm entitled to for 2015 in the form of a refund (or reduction in taxes owed)). This statement I doubt.

(c) All HealthPartners individual plans -- not just the ones available on the government exchange (in my case, Minnesota, the MNSure state exchange) -- are ACA compliant. That agrees with a HealthPartners brochure that says:

"Key plans meet all of the requirements of the Affordable Care Act. In fact, all HealthPartners individual plans meet the standards so you don’t have to worry!"

Creating "sit down jobs at community centers for self-entitled minorities" (FB: not hate speech)

Not hate speech or symbols, according to the Facebook Help Team.

Background: there was (and is) a Facebook posting about adding more bus shelters and improving some of the ones we have, in Minneapolis:

Robin Williams 1951 - 2014. Legend

"Obama's tendency to spend spend spend." YES. $64 B *LESS* in FY 2013 than in FY 2009

I know you were being sarcastic, but anyway I thought I should post this because it is a widely held misimpression...

Note: all figures in this section are actual, not budgeted. I only point out that Bush signed the FY 2009 budget.

[div style="display:inline; font-size:1.37em; font-family:monospace; white-space:pre;"] v-last Bush budget was FY 2009 (all figures are actuals, not budgeted)
[div style="display:inline; font-size:1.37em; font-family:monospace; white-space:pre;"] 2008 2009 2010 2011 2012 2013 Fiscal Year
[div style="display:inline; font-size:1.37em; font-family:monospace; white-space:pre;"] 2,983 3,518 3,457 3,603 3,538 3,454 Total Outlays, $Billions
[div style="display:inline; font-size:1.37em; font-family:monospace; white-space:pre;"] (450) (1,413) (1,294) (1,300) (1,089) (680) Surplus (deficit), $Billions
[div style="display:inline; font-size:1.37em; font-family:monospace; white-space:pre;"] (3.1) (9.8) (8.8) (8.4) (6.8) (4.1) Surplus (deficit), % of GDP

Source:
. . . http://www.cbo.gov/publication/43698 which links to the complete document at
. . . http://www.cbo.gov/sites/default/files/cbofiles/attachments/44716-%20MBR_FY2013_0.pdf

[font color = blue]So FY 2013 federal spending was 64 B$ (1.8%) LESS THAN FY 2009 (the last Bush budgeted year). [/font]

Since the nominal (current dollar) GDP increased by 17.58% between FY 2009 (a recession low point) and FY 2013 (see next paragraph), while federal spending dropped 1.8%, that means federal spending as a percentage of GDP dropped substantially during those 4 years -- from 24.46% of GDP to 20.42% of GDP (calculations below). Something to keep in mind when some rightie rants and raves about the socialist Obama spending us into the poor house.

In Current Dollars: GDP FY 2009 (2009 Q3) = $14,384.4 billion . GDP FY 2013 (2013 Q3) = $16,912.9 billion -- an increase of 17.58% over FY 2009.
Source of GDP figures: http://www.bea.gov/national/xls/gdplev.xls
where FY 2009 = Q4 2008 through Q3 2009. And FY 2013 = Q4 2012 through Q3 2013.

FY 2009: Spending / GDP = 3518/14384 = 24.46% . FY 2013: Spending / GDP = 3454/16913 = 20.42%

The Fiscal Year 2009 budget (Oct. 1, 2008 - Sept 30, 2009) was signed into law by G.W. Bush, and the CBO on January 7, 2009 (13 days before Bush left office) projected a $1.2 trillion deficit for FY 2009. So all but about $200 billion of FY 2009 spending and deficits was "baked in" before Bush left office.

Oh, BTW, the CBO projects a $459 B deficit for FY 2014, according to an AP 5/13/14 story, a 32% drop from the FY 2013 deficit.

Any advice on health insurers?

Yes, I'm searching for health insurance at this late date. DERP.

It might be too late to avoid the penalty already, but that's another post (my penalty would be a lot more than $95; the 1% of income part applies).

The 5 insurers for my zip code ( 1st suburb west of Minneapolis ) are (with some of the plan names to help with identifying purposes):

PreferredOne (plans named with "Select", "Choice", "Afford" )...

Group Health (most plans have "HealthPartners" in their name)

Blue Cross Blue Shield

Medica (some of their plans have "North Memorial" or "HealthEast" in their name)

UCare - its an HMO, so I'm not interested. https://www.healthsherpa.com/learn/types-of-insurance

Even after selecting some screening criteria (e.g. maximum acceptable deductible level), I'm still looking at 37 plans, so I'm hoping to eliminate some insurers.

Thanks for any advice.

I'm having a miserable time of it so far, understanding even the basics so I can at at least do some intelligent screening, rather than having to read a lot of the plan details to even know if a plan is of further interest or not -- http://www.democraticunderground.com/114211792

I know that it's a lot better than before (sigh) -- http://www.democraticunderground.com/?com=view_post&forum=1014&pid=758167

Health insurance fundamentals - deductibles, copays - Help! this makes no sense

Confusing -- I thought the patient paid EVERYTHING up to the deductible, and the insurance co. paid NOTHING. But John Waski says this:

Yes, it is indeed a travesty, an abomination

Here's my little list of all the reasons why Obama and his cheerleaders should all be hauled before the Court of International Justice in The Hague to be tried for crimes against humanity - [font color = gray, size = 1]sarcasm thingy[/font]

no more exclusion or higher premiums because of pre-existing conditions

copays are now capped

no more annual or lifetime caps

no more cancellations because one gets injured or sick

preventive services now free

insurance companies have to spend at least 85% of revenue on actual health care, else refund the excess back to consumers

covering adult children under age 26 on parent's plan.

Medicare Part D - Prescription drug donut hole closing

reliable birth control methods are now affordable (as in free)

People of the "wrong" gender are no longer charged more

Comparing plans is much easier

Can switch plans easily (because insurers can no longer use your medical history / pre-existing conditions against you) -- should make for more real competition

Don't have to fill out any long medical history forms (or short ones either), there are no medical questions asked (except about smoking). In the old days, if you forgot some yeast infection you had as a 6 year old child, that was reason to deny an expensive claim 50 years later on the basis of history form fraud. Meanwhile the state insurance regulators just sat on their butts.

Entrepreneurial types can now much more easily leave their employer and start their own business and still have insurance. And in general much reduces "job lock" for everyone, where people stayed with a job they hated because they needed the job-supplied health insurance -- http://news.yahoo.com/health-law-workers-ponder-quit-option-060047469.html

anything else?

---------------------
listmania tag

Republicans resort to trickery to outfox Democrats (fake Dem websites send contributions to Repubs)

Source: The Week

If you donate to a candidate online, pay attention to the fine print to make sure your donation goes to the candidate you want and not his or her opponent.

The National Republican Congressional Committee has launched a series of websites that look like they support a Democratic candidate for Congress, but instead direct contributions to the Republican Party instead.

The Tampa Bay Times interviews one donor who thought he was giving to Alex Sink's (D) congressional campaign. It even used the same blue and green color scheme as the candidate's official website.

But he didn't see the small print, which said, "Make a contribution today to help defeat Alex Sink and candidates like her."



Read more: http://news.yahoo.com/republicans-resort-trickery-outfox-democrats-172800372.html

Doctors say cutting food stamps could backfire

Source: Associated Press

Doctors are warning that if Congress cuts food stamps, the federal government could be socked with bigger health bills. Maybe not immediately, they say, but over time if the poor wind up in doctors' offices or hospitals as a result. Among the health risks of hunger are spiked rates of diabetes and developmental problems for young children down the road.

... Last year, research from the Robert Wood Johnson Foundation and The Pew Charitable Trusts estimated that a cut of $2 billion a year in food stamps could trigger in an increase of $15 billion in medical costs for diabetes over the next decade.

Other research shows children from food-insecure families are 30 percent more likely to have been hospitalized for a range of illnesses. But after a temporary boost in benefits from the 2009 economic stimulus, children whose families used food stamps were significantly more likely to be well than kids in low-income families that didn't participate, Children's HealthWatch found. About half of food stamp recipients are children, and 10 percent are elderly

... Dr. Thomas McInerny, past president of the American Academy of Pediatrics, said too often, poor families buy cheap, high-calorie junk food because it's filling, but it lacks nutrients needed for proper child development. The two main consequences are later-in-life diabetes, and iron deficiency that, especially in the first three years of life, can damage a developing brain so that children have trouble learning in school, he said.


Read more: http://news.yahoo.com/doctors-cutting-food-stamps-could-backfire-192904431--finance.html