Something I've been wondering: I've got a pretty fair amount of savings. Suppose I go on sabbatical for a year to do a startup, spruce up my github, whatever. For the sake of argument say I don't have COBRA.
Everything I've read talks about income, not net worth. If I'm not making income, am I stuck with Medicaid, even though I have a decent net worth? Or if I do a little consulting and make $20K, do I get subsidies on the exchange, even though I really don't need them?
Yes -- subsidies are tied to income, not assets (specifically, modified adjusted gross income [MAGI]).
There are reasonable arguments around the equity of this, but, as you describe, it actually opens a big door for wishing to try a more entrepreneurial venture -- especially for those with health conditions.
Interesting. What about medicaid though? From what I've seen there's a minimum income to get the regular plans on the exchange, and below that you have to go with medicaid (assuming there aren't net worth qualifications for that).
Below 138% of the federal poverty level, you would qualify for Medicaid. [1]
If you had ethical qualms about it (or couldn't pass the asset tests) you can absolutely purchase a plan on the Exchange -- you just wouldn't receive a subsidy.
[1] In states that have opted to expand it, see my other comment.
It's structured as part of your taxes. If you got too much subsidy during the year, you'd pay the difference next April, if you got too little, you'd get the difference back as part of your refund (or use it to offset the rest of your bill).
You're supposed to be able to elect to take a lower subsidy than you expect to qualify for, if you want to make sure you don't end up with an oversized tax bill next April. Presumably this will be part of some form when buying coverage on the exchanges. We'll know what it looks like in a couple days...
Good question -- you estimate what your income will be when you sign up, and then report actual income later (your subsidy will be adjusted to your actual income).
Everything I've read talks about income, not net worth. If I'm not making income, am I stuck with Medicaid, even though I have a decent net worth? Or if I do a little consulting and make $20K, do I get subsidies on the exchange, even though I really don't need them?