More confusion caused by the ACA, or ObamaCare, if you prefer.

I've posted before that the ACA is adversely affecting my life, and will cost me more than any single expenditure would. But... now, this is asinine at best, and beyond belief at worst.

I've recently hit a rough patch that has caused me to not be working since early June 2014. My wife and I have done our part throughout our lives; I'm 44 and she's 42 by the way, with neither of us drawing any benefits over the years. So we have paying into the system and such: Social Security, Medicare, and other taxes would have you think we've been doing our part, but there's a problem.

The California county in which I live states I'm eligible for medical benefits under ACA, without strings attached, because of my lack of income. Covered California, the state's exchange for said benefits says I'm not eligible. The county also states my wife is eligible for medical benefits because of her 'low' income status- around $750 monthly, and Covered California has no problem with that.

At the very least, over the past 10 years, I've contributed around $30,000 annually to the California coiffeur. That's $300,000 dollars to those lacking math skills. My wife has contributed about $8,000 annually, or around $80,000 over the same 10 year period. She gets benefits, and I don't, despite the fact I have contributed more to the system than she has. And we file taxes separately, so that's not an argument worthy of being made.

Can someone explain why I'm not eligible for any benefits, at all, despite my contributions to the system?

Please, justify the insanity the Democrats have used to justify this ACA... this Obamanation and insult to the producers within this economy.

a reply to: abecedarian

I sympathize entirely.

I would say that your major problem is living in California. I was born there.

Move to Texas... we actually have jobs here. Our state and local govts are also not going bankrupt.

I needed a copy of my birth certificate a while back. I was living in Tennessee at the time. I applied and paid the fee at the state website. Then I was informed it would take something ridiculous like 191 days to receive it.

Oddly enough, if I were born in Tennessee I could have received my BC from there in 3 weeks.

"Progressive" California, 6 months. "Backwards" Tennessee, 3 weeks.

To add to my post above, California had a program titled MISP, if I remember correctly, that would provide necessary medical services to the unemployed... it was "Medically Indigent Service Program" or something similar, and was funded under Medical/Medicaid.

So, previous to ACA, I would have been covered, but now, thanks to the Democrats, I am not covered despite their promises.


And as much as moving elsewhere is appealing, and trust me this: Texas is at the top of the list, it's a sad day when one cannot even afford the cost of relocation.

In case you're a Democrat, or otherwise similarly mentally challenged, let me sum things up:

Wife = $800 month income, has health care at no cost / no co-payment.
Self= $000 income, has no heath care at any cost / everything is a co-payment.

Thanks to ACA, the "Affordable Care Act"?
Please tell me what's "Affordable" about it?

a reply to: abecedarian

I often refer to it as the "Unaffordable Care Act".

It was supposed to be cheaper than the normal insurance due to a larger "pool" of payers.

Not so. Not to mention that many companies are withdrawing their own company subsidized health insurance or altering the pay ratios, not to the benefit of the employee. This is a direct result of Obamacare.

Living in your twin state of NY here, and scratch my head all the time at how the system is screwed up. Have been off of work for a few yrs now due to injury @ work. Late thirties, workers comp and ssd. Even though my doctor says you will never work again, I have to do job searches for workers comp otherwise I lose it. The medical I get is laughable at best and if I manage to settle a lawsuit against my employer I have to pay every dime back to workers comp even though I have to jump through hoops to get any.. I don't think the vast majority understand how backwards these blue states really are.

Obama.Care is extremely discriminatory.

Some standard excuses are;

"well we can't foresee everything"

"there's always somebody that slips through the cracks"

"we didn't think that was unconstitutional"

"we didn't know some people wouldn't be able to pay the deductibles"

etc.

etc.

I'm still confused as to why my wife has a job and gets benefits, and I'm unemployed and get none.

I'd like for a Democrat explain that simple fact, as in why the system intended to be 'fair' favors one over the other.

So, no one is willing to step up and defend the ACA?

To summarize-
Riverside County Department of Health and Human Services, which oversees SNAP and similar programs states I'm eligible for health care coverage.
Covered California says I'm not eligible.

Either way you look at it, the system IS BROKEN. The County uses State guidelines, based on Federal rules, to determine eligibility, as does the State's exchange. For the two to disagree shows the system IS BROKEN.

It's the government. Anytime you put them in charge, things will get worse, not better. And no matter how many times you tell progressives that, they will insist that it's always the fault of something else. They refuse to see.

And the ones at the top love it because they get power and that's all they care about.

Hippocrates.. That is the best way to describe progressives. They pray at the alter of politics.

This same ACA if passed by Romney, or republicans would be front page news on HuffPo daily with protests, code pink marches, and screams of "Republican War on the Poor".

But since this crap was their Party's grand scheme. It is OK

The new line is "well yeah, the ACA sucks because the Republicans wouldn't let us have single payer".

Like they could have done anything to stop it like this sham.

This is simply a War on the working. As always. Sorry your not in a progessive "privileged class" so you could get an exemption from this like the party elites.

I hate the aca, all it did was put more money into private insurance and they did the olé bait and switch on us all when presenting it but if you continue to call the very same people you want to try and defend it mentally challenged, no one is gonna bother.
Your problem sounds like it is with the state, which seems to be a big problem with the roll out. States doing their own thing with the aca.
One thing I noticed is you didn't give the reason why they said you don't qualify for coverage, so would you mind indulging that part?

originally posted by: Sremmos80 ...

One thing I noticed is you didn't give the reason why they said you don't qualify for coverage, so would you mind indulging that part?

Finally, someone asks.

They don't give a reason in the letters they've mailed to my house... on two separate occasions.


You didn't read that wrong- they sent two letters home, here.

The first was legitimate because I had only stopped working within the week prior to application. After that, they mailed me asking I to select a primary care physician stating I had been approved by Covered California for coverage and then... within a week of sending the information they asked for, I received the second denial letter.

Myself, 44 years old, with two adult children > 22 years old = no coverage; and has never used the welfare system.
My son, 22 years old, working at McDonalds = coverage and aid from 'welfare'; his mother has been homeless so....
My daughter, 24 years old, happily married and no assistance from government programs that I am aware of.
My wife, 42 years old, with no children = coverage.
My nephew, who my wife and I have been caring for since March 2013, received separate benefits from the state because both of his parents are MIA and have been homeless for at least the last 12 months, as far as anyone can gather.

So, despite being the most productive member of my local group, I'm the first they deny any coverage to.

If my use case isn't exemplary of the government sticking it to the middle class, there are none more worthy of that claim.

originally posted by: abecedarian
The California county in which I live states I'm eligible for medical benefits under ACA, without strings attached, because of my lack of income. Covered California, the state's exchange for said benefits says I'm not eligible.

If you really want an answer, you're not going to get it here; you're going to have to read the information on the web site more closely or contact the appropriate government agency and ask them. That will be more helpful than polling random strangers on the internet.

If you want this random stranger's opinion, I'd say eligibility is based on annual income, and if you've only been out of work since June, your annual income--whether on a calendar year or rolling basis--may be too high for freebies. If you applied for Medi-Cal, your annual income must be less than 139% of the Federal poverty level ($15,856 for an individual and $32,499 or less for a family of four). Since you've been contributing "at the very least" $30,000 to the state every year for a decade, you must make decent money (or own significant taxable property). I guess they tentatively approved you, then looked at how much you've made this year, saw you're over 138% of the poverty level, and reversed the tentative decision. Being a person of evident means, you should have sufficient savings to purchase insurance through a brief period of unemployment. Perhaps by the time your emergency fund has been drawn down, your annual income will be closer to the poverty level and you will be eligible for assistance.

It doesn't really matter how much you've paid in, or whether you or anyone in your family has ever received any kind of benefits. This is a social safety net, and the government has (at least for now) determined you have not fallen far enough to need it. You will probably get the same result when you apply for SNAP.

(How is your wife, with a $750/month income, contributing $8,000 to the state "coiffeur" annually?)

originally posted by: FurvusRexCaeli

originally posted by: abecedarian
The California county in which I live states I'm eligible for medical benefits under ACA, without strings attached, because of my lack of income. Covered California, the state's exchange for said benefits says I'm not eligible.

If you really want an answer, you're not going to get it here; you're going to have to read the information on the web site more closely or contact the appropriate government agency and ask them. That will be more helpful than polling random strangers on the internet.

Fair enough. But I'm not looking for answers, but rather trying to see how people justify how I'm treated by the system as being a good thing... and I'm not the only one, nor one worse off than many others.

If you want this random stranger's opinion, I'd say eligibility is based on annual income, and if you've only been out of work since June, your annual income--whether on a calendar year or rolling basis--may be too high for freebies. If you applied for Medi-Cal, your annual income must be less than 139% of the Federal poverty level ($15,856 for an individual and $32,499 or less for a family of four). Since you've been contributing "at the very least" $30,000 to the state every year for a decade, you must make decent money (or own significant taxable property). I guess they tentatively approved you, then looked at how much you've made this year, saw you're over 138% of the poverty level, and reversed the tentative decision. Being a person of evident means, you should have sufficient savings to purchase insurance through a brief period of unemployment. Perhaps by the time your emergency fund has been drawn down, your annual income will be closer to the poverty level and you will be eligible for assistance.

Well, they denied me, then re-evaluated things and approved me, then denied me again... which you'd know had you read my posts. Like I said, I received one denial letter, then another later asking me to chose a 'primary care physician' and after sending that in, received another denial letter.

And, again, as mentioned, MISP would have picked this up in a heartbeat and not caused anyone any extra expense. This was a program, in place prior to ACA, and did EXACTLY what ACA promised, but has been cut.

It doesn't really matter how much you've paid in, or whether you or anyone in your family has ever received any kind of benefits. This is a social safety net, and the government has (at least for now) determined you have not fallen far enough to need it. You will probably get the same result when you apply for SNAP.

(How is your wife, with a $750/month income, contributing $8,000 to the state "coiffeur" annually?)

Fair question. I stated her 'income' as take home, net in pocket, or whatever after withholding.

Strangely enough, since you mention SNAP, we qualify for that, and are receiving that so your assertion regarding that is null and void.

ACA determines eligibility based on 'household' income, at least from what Covered California is willing to tell me, so again, I ask... why is my wife covered, yet I'm not?

originally posted by: abecedarianACA determines eligibility based on 'household' income, at least from what Covered California is willing to tell me, so again, I ask... why is my wife covered, yet I'm not?

Because you made exponentially more. At least, according to your OP stating $30,000 annually to California alone.

As long as my math was right that would've put you at making more than $200,000 a year (12.3% income tax). Insurance plans are typically family plans. So...if your wife is eligible, you get insurance under her (which would automatically exclude you from eligibility). Unless you've both been applying for insurance as individuals then you're ineligible based on your annual income for this year.

Now, I don't know if you were ever under the impression that Obamacare would make health insurance 'free' for poor people, but that's not the case. Now, if you have absolutely no income, at all...try Medicaid. However, you're probably still ineligible this year because you've made too much money this year.

The short of it is that you've made too much money this year. Did you really think you just stopped working and suddenly the luxurious life of welfare would shower you in benefits?

a reply to: links234

There (that he made too much this year, yet now has no income) is one of the shortcomings of "the system". Meanwhile there are those who are capable of working, who choose not to, and yet they collect the max, year after year after year.

Our system, our society, our govt, our voters, our electorate are all screwed up. Positive incentives? Where? There are none as far as the Federal govt is concerned. Their incentives are all screwed up.

a reply to: bbracken677

Then where would his incentive to save and be prepared for when the safety net can't catch him?

I do think the system is has some faults, not enough is done to prevent the welfare cliff, for example. At the same time though, there seems to be a fundamental misunderstanding of how the system works, which leads to threads like this. Where the OP seems to think one thing should happen when it really doesn't happen.

The OP took this opportunity, not to seek help but to question the system and how it works. I'm not even sure they truly desire to understand it, they just want to point out the faults.

a reply to: FurvusRexCaeli
Agreed.

To the OP: The ACA has special enrollment if you've lost employment in a certain period of time, including COBRA, etc.

My guess is that you may be able to get help by digging deeper on the website and finding a person you can talk to either at your local Medicaid office or you Dept of Health & Human Services. Make some calls and see what your next steps are.

It is possible you are eligible for more than you are aware of now. I wish you the best in figuring this out. Sometimes it means jumping through some frustrating hoops. I have to do that all the time for my son with autism. Good luck!!!

- AB

originally posted by: AboveBoard
a reply to: FurvusRexCaeli
Agreed.

To the OP: The ACA has special enrollment if you've lost employment in a certain period of time, including COBRA, etc.

My guess is that you may be able to get help by digging deeper on the website and finding a person you can talk to either at your local Medicaid office or you Dept of Health & Human Services. Make some calls and see what your next steps are.

It is possible you are eligible for more than you are aware of now. I wish you the best in figuring this out. Sometimes it means jumping through some frustrating hoops. I have to do that all the time for my son with autism. Good luck!!!

- AB

Not trying to sound condescending here, but I have spoken with the local DHHS office, and that is what started this rant. THEY say I am eligible for benefits such as medical and dental coverage because of my lack of income. It's the STATE "Covered California" BS dipsquats that say I'm not eligible.

Unemployment and wage reductions do not come with a one year advance notice.

And, as I've alluded to, there were State and Federal programs ALREADY EXTANT that covered people in situations like I am facing now, but NOW the ACA and all of its RAM(itupmy)IFICATIONS, under the guise of providing for all, has done everything BUT provided for many.

The only thing it's really managed to do if further cement the relationships corporate interests such as BIG PHARMA and HEALTH have with government officials... predominately Democrat, by the way- just look at the campaign donation lists.