Romneycare vs. Obamacare

When Mitt Romney spearheaded the healthcare law here in 2006, supporters shouted that “Romneycare” ushered us into the mythical realm usually reserved for unicorns: Healthcare reform that worked.

Then the Feds joined the fray. Obamacare was upheld in a legendary 5-4 ruling by the Supreme Court this summer, so the Affordable Healthcare Act (AHA) jumped one of the last hurdles (besides re-election, of course!) toward enactment in 2014. What follows, kids, is the stuff of myth and legend.

I don’t have a roof, how the heck can I afford health insurance?
If you have no income, or make less than $15,000 a year, your state is expected to apply for federal Medicaid subsidies to pay for 90-100 percent of what it costs to cover its uninsured adults. The local health centers that many turn to now are expected to become even more crucial to the communities they serve. And if states opt in, there may be an opportunity for these centers to expand Medicaid offerings such as mental health services and services that benefit people with a qualifying disability. It is clear that whatever the outcome, community-based homeless assistance programs will need to pay even more attention to state policymakers to ensure that their neighborhoods get the expanded services they need.

What about the children?
Homeless kids on Medicaid and those already using state-run, safety net health services will be affected on a state-by-state basis, as each state under AHA applies for expanded Medicaid for the uninsured.

Romneycare expanded Medicaid for children up to the age of 18 whose families make between 133 percent and 300 percent of the federal poverty level. Obamacare expands Medicaid to adults, as well, but cuts off eligibility at 133 percent of the federal poverty level. The federal law lets families of four earning less than $29,000 annually join Medicaid.

I plan on having a job soon, and definitely by 2014, when Obamacare is expected to go into effect. Will my employer have to pony up?

Under Obamacare, small businesses qualify for tax credits by paying half of their employees’ insurance bill. The definition of small business here is fewer than 25 full time employees who each earn less than an average 50K per year. Obamacare doesn’t fine small businesses with fewer than 50 employees. Companies with more than 50 employees only pony up for fines if their employees qualify for tax credits via the new law. Romneycare fines businesses with more than 11 workers who do not pay “a fair and reasonable contribution” to employee health insurance.

According to www.endhomelessness.org, a lot is still up in the air. If states do get Medicaid expansion, which services will be covered? Will it all really happen by 2014? What if a state misses the 2014 deadline or decides not to take up the expansion? This story has a few endings, all of which hinge on who is elected this November. Here’s hoping we all live happily ever after in the era of the AHA.

–Patty Tomsky

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