2015-04-16 / News

Insurance penalty scheduled to go up next year

By Ben Meiklejohn Staff Writer

SOUTHERN MAINE – A special enrollment period in which people may still sign up for health insurance to reduce their penalty for the 2015 tax year will end April 30.

The Affordable Care Act, signed into law by President Obama in 2010, requires residents to obtain health coverage or else pay a tax penalty.

Bridget Mancini, the outreach and education coordinator for the Biddeford and Sanford offices of Planned Parenthood of Northern New England, said the next open enrollment period during which people may sign up for coverage in the Health Insurance Marketplace will start Nov. 1 and end Jan. 31, 2016. Although it is too late for uninsured people to avoid a tax penalty next year, the penalty can be significantly reduced if insurance is acquired before April 30, Mancini said.

The fine for not enrolling in a health insurance plan went into effect this year, as people filed their 2014 tax returns. The fine assessed is $95 or 1 percent of the person’s income, whichever is greater.

“Folks might think that’s not much, that they’ll just take the penalty next year,” said Mancini, “but next year it goes up to $325 or 2 percent of your income for 2015.”

For the 2016 tax year, the penalty will be $625 or 2.5 percent of a person’s income, she added.

Between April and November, the only way for people to sign up for health coverage through the governmentsupported Health Insurance Marketplace, also known as the “exchange,” said Mancini, is if certain special qualifying conditions are met. Some of those conditions are if people get married, have a child, adopt or foster a child, lose their other health insurance or if they lose their hardship exemption. Also, people turning 26, who are no longer eligible to be covered on their parents’ insurance, are eligible to sign up for coverage in the marketplace while the enrollment period is closed.

Mancini said anyone whose income level is below 133 percent of the poverty level, or $15,000, is exempt; anyone with an income of up to 400 percent of the poverty level is eligible for a subsidy.

Although the Affordable Care Act allows for states to expand their Medicaid coverage to include anybody below the poverty line, Maine has not chosen to do so. The only people who qualify for MaineCare coverage – Maine’s Medicaid program – are children and their parents living in poverty, disabled persons and seniors over 65.

Mancini said there are several organizations in Maine that serve as certified application counselors, or navigators, who are trained to help people determine which health care plan in the exchange is best for them. Among the organizations that can assist people, in addition to Planned Parenthood of Northern New England, are the Maine Lobstermen’s Association, Opportunity Alliance, Western Maine Community Action and York County Community Action.

Mancini said 75,000 people in Maine have signed up for coverage through www.healthcare.gov; Maine has the third-highest enrollment per capita. Mancini said 90 percent of Maine applicants have qualified for assistance for their health coverage, with an average premium of less than $100 per month.

“There are people who get plans for $20 a month or less who say they are so surprised and happy that they can get coverage,” Mancini said.

Some plans in the Health Insurance Marketplace offer eye care, and adults may also buy dental care separately, Mancini said; dental care is included in the health plans for all children.

According to the most recent data from the American Community Survey, in 2013, 147,000 Maine residents were uninsured.

For more information on how to sign up for a health insurance plan in the Health Insurance Marketplace before April 30, contact Planned Parenthood’s Biddeford Health Center at 282-6620.

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