These Millionaires Get Obamacare Subsidies

 
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This one weird trick can help even rich people buy Obamacare at sharply reduced prices. Really.

A number of wealthy individuals, some of whom were “disgusted” with Obamacare when it first went into effect, nonetheless are now taking advantage of federal financial aid available under that health-care law to help significantly reduce their monthly insurance premiums.

Carolyn McClanahan, a Jacksonville, Fla., financial advisor and medical doctor, told CNBC that she’s steered at least five such clients, whose individual net worths range between $1 million and $3 million, toward buying Obamacare health plans because of the federal subsidies available due to their taxable income levels.

Those clients are saving between $4,600 and $8,800 in annual premium payments as a result of subsidies. On top of that, McClanahan said, those customers are getting extra financial help to pay their out-of-pocket health expenses — the copayments, coinsurance and deductibles that aren’t covered by their insurance plan.

The idea of giving rich people discounted Obamacare plans raises the eyebrows of even McClanahan’s clients, who were initially skeptical when she described the option.

“Everybody was like, ‘Are you sure this is going to work?'” McClanahan said of her clients’ reaction.

“And I’m like, ‘Yes, I’m sure it’s going to work.'”

And it’s legal as well, because of the way the Affordable Care Act focuses on income rather than net worth to establish eligibility for Obamacare aid.

“The law was set up that way, so I’m going to help them take advantage of it.”

The ACA was enacted primarily to help uninsured people get health coverage at a price they could afford. To help do that, the ACA authorized the federal government to issue tax credits, or subsidies, to people with low or moderate incomes who buy health plans sold on government-run Obamacare exchanges.

For 2016, individuals with annual taxable income between $11,770 and $47,070 qualify for such aid.

McClanahan’s Obamacare customer clients were all retirees who stopped working before they were 65 years old. They no longer had the option of getting health insurance through their jobs, and were too young to qualify for Medicare, the federal health insurance program for senior citizens.

Those people, while having relatively high net worths due to investments and real estate, also were in a position to have taxable income that was low enough to qualify for Obamacare subsidies.

But that income could still be high enough to keep them above 100 percent of the poverty level. If their incomes fell below that, they would not qualify for the subsidies to help buy private plans, and also would not qualify for government-run Medicaid because Florida rejected expanding that program to cover more low-income people.

McClanahan said she helped the clients structure their income stream — and the taxable component of it — “just right.”

“The first thing you’ve got to figure out is how much money do they need to live on,” she said.

The clients, all of whom had paid off their homes, needed “anywhere between $5,000 and $7,000 a month” to live on, she said.

Helping that strategy was the clients’ use of bond ladders, which gave them steady income as the bonds matured over time, and also spun off interest payments from the bonds’ coupons. While the interest payment is taxable, the initial investment in the bonds is not, McClanahan noted.

“For most people, we’re aiming for like $18,000, $19,000 in income” that is taxable, she said.

That level of income also was low enough that all of the clients qualified for the added Obamacare aid of “cost-sharing reductions,” which are available to people with taxable incomes below about $29,000 who enroll in so-called silver plans. Without cost-sharing reductions, silver plans cover about 70 percent of customers’ medical expenses, with the balance owed out-of-pocket by the customer.

Angie Koury Lieb, a Jacksonville insurance broker, helped McClanahan’s clients get into those plans, which in Florida are sold on the federally run Obamacare exchange HealthCare.gov.

Lieb said that some clients initially “were pretty disgusted about the subsidies and how it all works” when Obamacare first began taking effect.

“I think a lot of it was very politically motivated, that they didn’t necessarily agree with the Affordable Care Act itself,” she said.

“Then they said, ‘Well, shoot, I’m going to try to qualify myself,'” Lieb said. “I think they were more, ‘If I can’t beat them, join them.'”

Lieb said that when she helped McClanahan’s clients sign up on HealthCare.gov and pick their plans, “they were usually pretty pleased and excited” when they saw how much subsidies they would be getting to lower their premiums.

On the lower end of the prices, one client qualified for a $423-per-month subsidy, which reduced the price of their plan from $663 per month down to $240 per month, she said. On the high end, another client qualified for a $737 subsidy, reducing their premium from $1,172 per month to $435.

And “with the cost-sharing reduction, I think people were extremely happy,” Lieb said. “It reminds people of what health insurance looked like 25 years ago, when they had a $10 copay and no deductible.”

Lieb and McClanahan both noted the fact that their clients, due to their financial position, came under scrutiny from the government when they applied for their subsidies. To obtain those subsidies, customers have to indicate how much income they expect to earn in the coming year.

Every client, McClanahan said, was flagged for review of their subsidy eligibility when they applied because tax forms revealed they previously had high incomes.

“We had to provide a lot of supporting documentation,” McClanahan said.

Clients also must be conscientious about reporting income changes during the course of the year. If people end up earning more than they had estimated when they applied for their subsidies, they could end up owing some or all of the subsidy back when they file their tax returns the following year.

Written by Dan Mangan of CNBC

(Source: CNBC)

Medicare Part B Premiums Will Rise by 16 Percent in 2016 for Some Seniors

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The Centers for Medicare & Medicaid Services has quietly made it official: Medicare Part B premiums for 30% of Medicare recipients will jump next year, but not as high as they would have without the bipartisan budget deal passed late last month. While 70% of Medicare beneficiaries will have their premiums held to the same $104.90 per person a month they paid in 2015, the unlucky 30% will face a 16% increase in their base premium from $104.90 to $121.80 per person per month. And the 5% of beneficiaries who pay a high income surcharge, will pay a 16% increase in that surcharge, along with paying the higher base.

Without the budget deal, both the base and the surcharges for Part B, which covers doctors’ and outpatient services, would have risen by 52%. “By historical standards it (16%) is a very, very large increase,” says Joe Antos, health policy expert at American Enterprise Institute. “It’s not as much as it would have been, but it’s big.”
As for the high income premium payers, they’re “in a permanent state of shock,” Antos observes. Graduated high-income premium surcharges for seniors kick in for singles with a modified adjusted gross income of more than $85,000 and for couples with a MAGI of more than $170,000. (The premiums for 2016 are based on the AGI reported on 2014 tax returns.)

An individual earning more than $85,000, but less than or equal to $107,000, will pay $170.50 a month in 2016, up from $146.90 a month this year. A wealthy senior couple with AGI of $428,000 or more will pay $9,355 a year in Part B Medicare premiums, up from $8,056 in 2015.

The Part B premium debacle is set against the backdrop of falling oil prices, which means that overall inflation has been almost nil, and Social Security recipients will get no cost of living increase for 2016, their first year since 2011 without a boost. A 1987 “hold harmless” provision, designed to keep recipients’ Social Security net checks from shrinking, provides that for ordinary retirees who have Part B premiums deducted from their Social Security checks, the standard premium can’t go up in any year by more than the extra dollars they’re getting as a cost of living adjustment in their Social Security checks. That protects 70% of recipients.

But medical costs, and in particular Medicare’s costs, are increasing. And a different law requires that premiums paid by beneficiaries cover 25% of Part B total costs. The odd result: the increases the 70% of recipients don’t pay are shifted onto the 30% who aren’t protected by the hold harmless provision. That unlucky 30% includes those who are better off, those who don’t have Medicare premiums withheld from their Social Security, and those who didn’t receive Social Security in 2015.

Here’s the table of what you’ll pay per month for 2016, depending on your income, for individuals and for couples filing a joint tax return:

Beneficiaries who file an individual tax return with income: Beneficiaries who file a joint tax return with income:

Income-related monthly adjustment amount

Total monthly premium amount

Less than or equal to $85,000 Less than or equal to $170,000

$0.00

$121.80

Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000

48.70

170.50

Greater than $107,000 and less than or equal to $160,000 Greater than $214,000 and less than or equal to $320,000

121.80

243.60

Greater than $160,000 and less than or equal to $214,000 Greater than $320,000 and less than or equal to $428,000

194.90

316.70

Greater than $214,000 Greater than $428,000

268.00

389.80

Note these officially-released numbers are slightly higher than those talked about after the budget deal: $120.70 for the base monthly premiums for those not held harmless. “This is actuarial nitpicking at its finest,” Antos says.The last time we saw hikes like these was in 2011, when premiums for high income folks rose 15%, and Antos warns that we could see them again for 2017. Starting in 2020, the high income premium brackets will be adjusted for inflation, so that promises to keep some out of reach of the income surcharges. But don’t count on it. “We’re going to have several years of Congress looking for money from Medicare,” says Antos. “It’s easy to remove that indexing. It’s always easier to pick on high income people than anybody else.”

Is there a way around these high premiums? Use strategies now that will let you control your adjusted gross income in retirement. The income-related premiums are based on your income two years prior. Planning ahead with Roth conversions can help manage your bracket in retirement. Fidelity’s latest retiree healthcare cost is $245,000 a couple and that’s not including income-related Part B surcharges.

If you have a high deductible health insurance plan now, fund a health savings account and invest it until you need it for medical expenses in retirement (you can use money in a health savings account for Medicare premiums but not for Medigap policies). It’s possible to build a $150,000-plus health savings account. If you’re already getting hit with Medicare income-related premiums, bunching income into one year can help keep premiums down another year.

Written by Ashlea Ebeling of Forbes

(Source: Forbes)