I have been having some issues with my attempt to obtain insurance through the exchanges, as well as to comply with the ACA law. Since I have read some "help" related diaries here - and haven't had much luck with the helpline - I thought I would run this by the helpful eyes here at Daily Kos to see if anyone has any suggestions. Details below.....
The details:
Married couple, no children, Illinois resident (meaning we have no state site - we go through the main exchange site), earning about 48K per year total (meaning we should be eligible for some subsidy as we make less than the 62K cap).
Our employers offer insurance, but neither offers ACA compliant policies, and both employers' literature admit to this fact, so to obtain ACA compliant insurance we must buy through the exchange.
In mid-November, we apply through the healthcare.gov site, which seemed to go somewhat smoothly. We get back a PDF letter stating that we are both eligible for coverage, but below that, it states that they will need more time with our app to determine if we get any cost savings - we assume this is "the subsidy" which would reduce our costs.
We then have our page show the "set" option to look at plans. So we look at those plans - the lowest cost option was $406 per month but had providers all one hour away from us (we live in an area with 400K people), the next lowest cost was $560 (still in bronze level) and the lowest cost silver plan (which we are supposed to be able to get for no more than 9.5% of our income) is over $600 per month. BTW, nonsmokers, so there shouldn't be an extra charge for that, either.
So we call the helpline - on three separate occasions, and asked about the subsidy. They stated that we did not qualify, and could not give us any answers as to why we didn't qualify for tax subsidy assistance/premium reduction. They simply stated that we could appeal, which would take 90 days to get an answer (which means that there's no way in hello we have active insurance by the first of the year). The helpline people seemed to not know much about the intricacies of how these applications or policies work, and simply said "you don't qualify for subsidies - you can appeal" without giving me any nuts-and-bolts reasons for why this is so.
I am supposed to be able to obtain a silver level plan for no more than 9.5% of our total income and am unable to do so. $600 per month is close to 20% of our after tax take home pay and a tough pill to swallow, especially when the policies have a $6,350 deductible on each of us - meaning that we could have to shell out $13K+ if we actually have to use one of these policies beyond basic checkups/screenings before we see any benefit.
A couple of other details I wonder about:
On the application, there was a section that asks if our employer offers insurance, and if yes is checked, then are the policies offered ACA compliant (we answered yes, it's offered but no, they are not ACA compliant). We wonder if the fact we selected "yes, it's offered" somehow made us not subsidy eligible in their system.
We also used Mozilla Firefox when doing the app, and wondered if that caused "agreement" issues with the site and all of the info didn't convey properly to the site.
I called the helpline, in hopes of going over that app, but didn't get any help beyond "yes, we got your app, no, you are not subsidy eligible" without being able to go over that app and make sure it all translated properly to them. I got the distinct feeling that the helpline personnel did not know much details as to what they were doing or how this system is to really work.
So I wonder where I should go from here, and also want to know if I am correct in the assumption that our $48K income for a couple is supposed to be subsidy eligible or if anyone knows why it wouldn't be.
Ideas?