On Wednesday, I did my 2013 taxes. I filed them and paid them. I generally get some panic attack symptoms when I do my taxes. Once it's submitted, those symptoms usually go away. It didn't this time, and that's why I'm writing this. The writing seems to help. The taxes themselves went smoothly and I only had to pay a relatively small amount (6% of what I made) since I'm so far below the poverty line. Yay for the EIC for making it slightly less awful. I make so little, I don't actually pay any income tax...only self-employment tax. It's the portion of taxes paid by the business if you're lucky enough to be employed.
There's a scene in an episode of Star Trek: The Next Generation where Captain Picard is trying to convince Geordi to bring not-up-to-date Scotty on an away mission. In it, Picard talks about how Scotty just wants to feel useful. Geordi brings Scotty along and together, they save the day. I just want to feel useful, so I try to work any way I can. Unfortunately, by working, I'm the one whose day will need saving. Follow me under the cut to find out why. (I'm more of a cartoon kind of guy, but that scene stuck with me.)
~ First, some background ~
I lost my job in 2009. I got my job straight out of school, and everyone was aware of my special needs. The environment and people were already familiar. I have social anxiety disorder diagnosed by a doctor back when I could afford one. (I didn't just read Wikipedia and say, "I must have that.") Once I was terminated, I no longer had insurance, so I no longer had a doctor or any medication. Because I was too old when the "stay on your parents' insurance until you're 26" rule came into effect, I remained uninsured. I eked out a meager living with calls for help from people who remembered how well I did when I was employed and otherwise survived on the charity of family. Now, knowing people who are willing to pay me is becoming a liability (technically known as the Shared Responsibility Provision, more on that later) that will grow until it surpasses my income. Without tackling my social anxiety, it is impossible to get a job through normal means, and highly unlikely through word-of-mouth recommendations from other people. The social anxiety also transfers over to the phone. Generally the physical symptoms go away after a while if I know the person on the other end (yes, the symptoms are still there even if I know the person), but if I don't, they won't. So, to review: without insurance, I can't tackle my social anxiety. Without a job, I can't get insurance. Catch-22 complete. There's more to this, but since I marked this as a public entry, I had to leave some bits out.
~ Hardships and Exemptions...Maybe ~
Now, I have to hurry up and get covered or Obamacare is going to sock me with a $95 well-maybe-you-should've-earned-more-
money "shared responsibility" fine. By 2016, that fine alone will be more money than I make in a year, unless by some miracle, I get a job. Luckily, they have exemptions for hardships, though the process of being granted an exemption due to income has a really gigantic flaw: you have to know how much money you're going to make for the year and be able to prove it. I have no idea how much I'm going to make in the next ten months and I really don't know how I'd prove it. I make money in random spurts. It's not possible for me to estimate because I don't know when someone's going to call me and ask for help. (Last year, I made nothing for seven entire calendar months out of the year.) Luckily (?), you can apply for the hardship on your taxes the following year, and hope you get it. If not, you have to pay the penalty and still have no coverage. So here are the hardships listed on the federal exchange site: You were homeless.Nope...thanks to my parents. Should I be? You were evicted in the past 6 months or were facing eviction or foreclosure.Nope...parents again. You received a shut-off notice from a utility company.I'm not responsible for the utilities. You recently experienced domestic violence.Luckily, no. You recently experienced the death of a close family member.Also, luckily, no. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.It's not even my property. You filed for bankruptcy in the last 6 months.I sure hope this isn't what it'll take. You had medical expenses you couldn’t pay in the last 24 months.I have no idea when I last had any medical expenses. I just don't bother going because I don't have money. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.Nope. I am that disabled family member. You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.I hope to never have a kid. I don't have patience for them, so if I had one, maybe I'd end up qualifying for the incarceration exemption just a little further down. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren't enrolled in a QHP through the Marketplace.I make too little for this to apply.
- You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act. Texas didn't expand Medicaid, but to get this exemption, you have to try and fail to get Medicaid first. I looked at the form for Medicaid and it doesn't look like I can even fill it out. There are too many questions about what to put in certain spots or what to do if something doesn't apply. For help, you have to call. Once you finish, you have to run the form over to an office and sit for an interview. They might interview over the phone, which is just as bad. If you didn't read the section above, you probably won't know why those are not possible. As if that form wasn't bad enough, it says right on the form that you have to have kids or be pregnant in order to qualify. It does say you can be disabled, but it doesn't define what that is or who has to say it. If you need a doctor to say you're disabled, and you need to already be disabled to pay the doctor, how do you get past the Catch-22?
Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable.It was cancelled because I have no job.
Well, I only made it through those hardships with only one potential hardship. But surely not having a job for four years is a hardship? Well, as it turns out, they really don't care about whether you have a job or not; they only care about income. (I talk a little more about that in the next section.) There's also some "statutory exemptions", some of them sounding like hardships:
You’re uninsured for less than 3 months of the yearI really don't see myself amassing enough money to buy insurance on the individual market by the end of March. I discuss prices in the next section.
- The lowest-priced coverage available to you would cost more than 8% of your household income The lowest-priced coverage available to me would cost over three times my annual income, assuming I make the same amount this year as I did last year. And that was the "Bronze" plan with a $6000 deductible. I have no idea how coverage that requires you pay $6000 out of pocket before you get any help is considered "coverage". See the next section for some math about how useless the cheapest policy is.
You don’t have to file a tax return because your income is too lowIf I made the same amount of money through a job, I wouldn't have to file. But if you make anything that counts as self-employment income, you always have to file, even if it's just a couple dollars. In other words, if I made $10000 working at McDonald's, I wouldn't have to file, but since I made a couple hundred dollars freelancing, I don't qualify for this. I probably wouldn't qualify for it if I made $10 of self-employment income. You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services providerNope. You’re a member of a recognized health care sharing ministryI don't even know what this is. You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and MedicareNope. I might have to find a religion just to avoid getting fined. You’re incarcerated, and not awaiting the disposition of charges against youI sure hope going to prison is not going to be what it takes to avoid this. You’re not lawfully present in the U.S.Sometimes I wish I was Canadian so I wouldn't have to deal with this, but I'm lawfully present.
My only hope is item number 2. I alluded to the problem in item number 3: If you are unemployed and try to get self-employment income, regardless of amount, you suddenly have to fight to not pay the penalty. In my case, it's a disincentive for me to actually get any money. That disincentive grows with the penalty until I'd have to pay more for the penalty than I make in income. Sadly, I already got money this year, so I can't just avoid income like the plague until I magically get health insurance. Also, if I am unemployed and do get a job, I have to hope I get it before the end of March or I'll be subject to the penalty because my money is supposed to magically go back in time and pay to cover me from April onward. That's because the penalty kicks in if you're not covered for more than three months out of the year and it takes time to process applications. The sources for this section are the federal Health Insurance Marketplace and the IRS. I guess I should talk about my attempts to use the Marketplace.
~ You get nothing! You lose! Good day sir! ~
We've all heard the horror stories about the ObamaCare website. Now I have one, but it's different from the usual. I figured I wouldn't qualify for any help paying for insurance because I make to little, but they also say they forward the information to whatever state you live in if you might qualify for something there. So I tried to sign up for the website. It then asked me to provide information, except it didn't like what I provided. I think this has to do with people not knowing what to do with those with two middle names. My Social Security card has my name as it appears on my birth certificate. My taxes just have my middle initial rather than my middle name. The person who issued my state ID didn't put a space in the middle. They didn't even ask for that much information, so I can only imagine they didn't like my middle name. It said that I had to verify my information...by calling Experian. Never mind that I have to call a credit rating bureau to verify my information and their information is 90% inaccurate, but I have to call. Since I don't know what they're going to ask, I have no idea how to prepare for the call. That's a requirement when I find myself having to make a call. (If you didn't read the background section and you're confused, go back and read that section. If you're still confused, read about telephone phobia. If you're still confused after that...I don't know what to tell you.) I actually tried to call, since my heart rate was already really high as I read about how ObamaCare would potentially screw me over. All I got was an automated message saying to call back within business hours, which start when I'm asleep and end about an hour after I wake up. How...helpful. (I'm long-term unemployed, what do you expect my sleep schedule to be like?)
Even if I did call and got through, and they straightened out everything so I could use the site properly, it wouldn't make a difference anyway. I don't qualify for any help paying for insurance. As the exchange site says (bolding in original):
As the chart shows, if your state ISN’T expanding Medicaid, you have limited income, and you don’t qualify for Medicaid under your state’s current rules, you don't qualify for either Medicaid or lower costs on private health insurance.
So no matter what I do, whether I call and get into the exchange site or I fill out all the pages of forms for Medicaid I can't qualify for, I will get nothing. I'd like to think I'm just an edge case, but it's a very big edge. Even if I made $10K more than I expect this year, I still wouldn't qualify for any help. If I magically, somehow, make between $11,490 and $45,960, then I magically get help paying. $20-50 a month (or $240-600 a year for the math averse) isn't unheard of. So what about the people who don't qualify, like me?
Because I couldn't get the site to like me enough, I just browsed through the plans. The surprisingly not catastrophic, cheapest plan available costs $129 per month (or $1548 per year). The deductible is $6000, so you actually have to pay $6000 out-of-pocket before the plan kicks in. If you add those numbers together, you need $7548 in medical spending per year before the plan has any use. If I got it, I'd be paying $1548 a year for the privilege of being able to say I have health insurance, even though I can't afford to use it. That's the same reason they said no one could have "catastrophic" plans, and yet, the approved plan is basically catastrophic.
~ But You Wouldn't Complain without Proposing a Solution ~
So far, I've limited things to what the law says and not who made it that way, since I've been trying to make this an apolitical entry. It's pretty hard to avoid politics when discussing a politically-charged issue. But as far as a solution, I'm going to go all-out and say we should copy Canada. Sure, it's not perfect (try parking at a hospital in Canada and see how much it costs), but it's far better than the system here, which is expensive once you make it in the doors. Imagine the savings for businesses not having to worry about getting coverage for their employees. If you say, "but waiting lists!", I respond that it's better you die waiting for care than die because you could never get any in the first place. (More people die from not having health insurance than from kidney disease. If you click that link, scroll down, the numbers are on the last page.) ObamaCare only forces people to pay for health insurance or get increasing fines. It makes insurance easier to get though if you're working, but with the Medicaid expansion section eviscerated by the Supreme Court, it becomes [unintentionally...maybe] cruel for the poor. It's mostly stick and not much carrot. Why won't anything change? Because some people are getting very rich because of the way things are now and they'll use that money to convince everyone that things are perfect just the way are. (They could also use that money to convince people that up is down, left is right, and that we should walk backward because some people will believe anything with a well-produced, ubiquitous ad and/or repeated enough.) With that politically unrealistic solution proposed, what are some more realistic solutions that work within the law as it exists now?
- Move to a U.S. territory: Being a citizen of a territory removes the requirement for some reason. But I'd have to move by the end of March and I don't know anyone in a territory. Besides, I couldn't afford to move or I wouldn't be in this situation.
- Get gainfully employed by February 14, which happens to be today: After February 15 (which is a Saturday this year), health insurance coverage won't kick in until after March 31, so unless you knew you'd get gainfully employed and had the money to purchase insurance without any help on the individual market, you will get fined. (See the last paragraph in the second section) I think it might be a little later, since getting insurance that kicks in on April 30 means you were insured for the month...or something weird like that.
- Die before getting taken to the hospital and before filing taxes: This is morbid, but I wouldn't have to worry about being fined! I wouldn't be able to worry about anything for that matter.
~ The Conclusion ~
I shouldn't have to worry about this, but I do. I have to worry about whether I'm making too much money, not enough money, and what time of year I get a job, if I get one. I have to worry about potentially being denied the one exemption I qualify for and having no recourse.
The TL,DR version: I don't make enough money to buy insurance on my own and I don't make enough to qualify for any help, but I still might have to pay the tax penalty for not having insurance. The penalty incentivizes not working and makes it more expensive to get employment from April to December than January to March for the long-term unemployed. Also, I can't remember if I ever wrote an entry that had more than 3000 words...