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Individual Health Insurance Plans Arizona Question & Answers

2014 November 7
by Sarah Fields

Richard asks…

Is McCain out to RAISE YOUR TAXES?

It sure looks like it, and I’m a CPA. McCain wants to TAX ALL medical benefits that employers provide to employees. That would raise taxes to a STAGGERING LEVEL because the cost of medical benefits is huge and is rising all the time, thanks to the lack of Universal Health Insurance.

McCain says he will offer those who buy their own medical insurance a tax “break” of $2,500 for individuals and $5,000 for families. That is NOTHING, and as the medical costs soar for those opting to pay for medical insurance, that amount will seem like chump change, if it doesn’t already.

Who would have thought that McCain wants to raise taxes? I’m glad he told me about his plan now. McCain obviously wants to tax the crap out of ordinary citizens and give all the tax breaks to big business so that companies like the oil companies can steal even more of America’s money.

I’m voting for Obama.

Please note that the Yahoo article still tries to slant the facts to favor McCain, which shows how biased Yahoo is. They quote a guy from the American Enterprise Institute. These are the same neocon scum that urged invading Iraq to get those (nonexistent) weapons of mass destruction. Did they quote a REAL expert in health care? No way. That’s Yahoo for you.

Sarah Fields answers:

There is no question McCain’s program will raise, not lower taxes……In fact, McCain admits that it will!

“For millions of middle class families, the credit is smaller than the current tax subsidies, meaning that it is in fact a tax increase,” said Elizabeth Edwards, the wife of former Sen. John Edwards, D-SC, and a senior fellow at CAP. “I know he’s pledged not to have any tax increases, but this in fact will work as a tax increase.”
McCain’s tax credit could morph into a tax hike because the credit grows only at the rate of inflation (about 2 percent a year), while current tax subsidies keep up with health insurance premiums (which are growing at about 7 percent per year).

For a couple earning $40,000 per year and paying an average premium of $13,800, McCain’s new tax credit would cut their taxes by $50 in 2009.

“[B]ecause the credit quickly falls behind rising premiums that are the basis for the current tax break, the family would pay $1,169 more in taxes in 2013. The family would pay $2,809 more in taxes by 2018,” write James Kvaal, Peter Harbage, and Ben Furnas, the report’s authors.

The McCain campaign does not dispute the study’s assertion that the Arizona senator’s proposed tax credit would offer a smaller subsidy over time than the current exclusion if health premiums continue to grow more quickly than inflation.

Donna asks…

Question about the S-CHIP program?

I work in state government, and I’m trying to understand how the SCHIP program works in relation to each state. Our state is suing President Bush and the Department of Health for not allowing it to redefine its qualifications for children who are in financial need for health insurance. My question is this, if the feds did allow for New York or Arizona to expand the rolls, would it they have to pay more for the program? What is the percentage between what a state pays for SCHIP and what the feds contribute. Does anyone know. I’m trying to familiarize myself with this issue. My party at the national level could not override the President’s veto. Any suggestions for familiarizing myself more with the program?

Sarah Fields answers:

CMS Administers the State Children’s Health Insurance Program (SCHIP). Program benefits became available October 1, 1997 and will provide $24 billion in federal matching funds over 10 years to help states expand health care coverage to over 5 million of the nation’s uninsured children.

The State Children’s Health Insurance Program (SCHIP) is jointly financed by the Federal and State governments and is administered by the States. Within broad Federal guidelines, each State determines the design of its program, eligibility groups, benefit packages, payment levels for coverage, and administrative and operating procedures. SCHIP provides a capped amount of funds to States on a matching basis for Federal fiscal years (FY) 1998 through 2007. Federal payments under title XXI to States are based on State expenditures under approved plans effective on or after October 1, 1997.

SCHIP Regulations 42 CFR 457

The regulations are contained in the download below. They are organized in Zip files by Subpart as follows:

Subpart A – Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies.

Subpart B – General Administration; Reviews and Audits; Withholding for Failure to Comply; Deferral and Disallowance of Claims; Reduction of Federal Medical Payments.

Subpart C – State Plan Requirements: Eligibility, Screening, Applications, and Enrollment.

Subpart D – State Plan Requirements: Coverage and Benefits.

Subpart E – State Plan Requirements: Enrollee Financial Responsibilities.

Subpart F – Payment to States.

Subpart G – Strategic Planning, Reporting, and Evaluation.

Subpart H – Substitution of Coverage.

Subpart I – Program Integrity.

Subpart J – Allowable Waivers: General Provisions.

Subpart K – State Plan Requirements: Applicant and Enrollee Protections.

Like Medicaid, SCHIP is a partnership between federal and state governments. The programs are run by the individual states according to requirements set by the federal Centers for Medicare and Medicaid Services. States may design their SCHIP programs as an independent program separate from Medicaid (separate child health programs), use SCHIP funds to expand their Medicaid program (SCHIP Medicaid expansion programs), or combine these approaches (SCHIP combination programs). States receive enhanced federal funds for their SCHIP programs at a rate above the regular Medicaid match.

States with separate child health programs follow the regulations described in Section 42 of the Code of Federal Regulations, Section 457. Separate child health programs have much more flexibility than Medicaid programs. Separate programs can impose cost sharing, tailor their benefit packages, and have a great deal of flexibility in eligibility and enrollment matters. The limits to this flexibility are described in the regulations, and states must describe their program characteristics in their SCHIP state plans. Out of 50 state governors, 43 support SCHIP renewal. [7]

In Ohio, SCHIP funds are used to expand eligibility for the state’s Medicaid program. As a SCHIP Medicaid expansion program, all Medicaid rules and regulations (including cost sharing and benefits) apply. Children from birth through age 18 who live in families with incomes above the Medicaid thresholds in 1996 and up to 200% of the federal poverty level are eligible for the SCHIP Medicaid expansion program. In 2004, the maximum annual income needed for a family of four to fall within 100% of the federal poverty guidelines was $18,850, while 200% of the poverty guidelines was $37,700.

Other states have similar SCHIP guidelines with some states being more generous or restrictive in the number of children they allow into the program. SCHIP Medicaid expansion programs typically use the same names for the expansion and Medicaid programs, and separate child health programs typically have different names for their programs. A few states also call the SCHIP program by the term “Children’s Health Insurance Program” (CHIP).

Betty asks…

Ladies, if you want birth control on your insurance plan, should you have to deal your boss?

A.) that you’re getting it and B.) why you’re getting it

Arizona Republicans think so.

“When a female worker uses birth control pills, which can be used to treat a number of medical conditions, the bill would allow an employer who opted out to require her to reveal what she was taking it for in order to get reimbursed.”

Tell your boss, that is.
The best part of all this is that most Conservatives reading this instead of saying, “OK, this has gone too far. Let’s just get back to the economy, taxes and foreign policy.” will instead double down.
Toxic – they should be required to provide health insurance that comply with federal law. An employer doesn’t have to provide insurance but an insurance plan is required to carry a certain number of things to prevent cherry picking. This item falls under Title VII of the Civil Rights Act of 1964, which has been upheld as Constitutional by SCOTUS numerous times.
ADD – Title VII gave congress the authority to create the EEOC and enforce the provision therein through appropriate means. Subsection K of Title VII of the CRA of 1964 reads as follows, “(k) The terms “because of sex” or “on the basis of sex” include, but are not limited to, because of or on the basis of pregnancy, childbirth, or related medical conditions; and women affected by pregnancy, childbirth, or related medical conditions shall be treated the same for all employment-¬related purposes, including receipt of benefits under fringe benefit programs, as other persons not so affected but similar in their ability or inability to work, and nothing in section 2000e-2(h) of this title [section 703(h)] shall be interpreted to permit otherwise. This subsection shall not require an employer to pay for health insurance benefits for abortion, except where the life of the mother would be endangered if the fetus were carried to term, or except where medical complications have arisen from an a
ADD 2 – arisen from an abortion: Provided, That nothing herein shall preclude an employer from providing abortion benefits or otherwise affect bargaining agreements in regard to abortion.”

Subsequently, it has been the position of the EEOC the denial of birth control to women violates both the letter and spirit of the aforementioned text. (“The terms “because of sex” or “on the basis of sex” include, but are not limited to, because of or on the basis of pregnancy, childbirth, or related medical conditions; and women affected by pregnancy…”)

With respect to the fallacious religious liberties argument, the Courts and Congress have occasionally granted individuals and communities immunity from otherwise applicable federal law. For example, a self-employed Amish individual does not have to pay Social Security or Medicare tax because they believe that care of the elderly is strictly a purview and obligation of the family and immediate community. In the case United States v. Lee, an Amish
ADD 3 – business owner argued that because of this exemption, he should not have to pay the employer’s portion of Social Security and Medicare tax. The Courts disagree and found that indeed must. Whilst it has been established that Courts occasionally allow for individual or communal exemptions, they have not allowed an employer to impose such standards upon their employees.

Sarah Fields answers:

No! What goes on between an individual and their health care provider is not any one else’s business, except for those that individual WANT to share that information with…Period!

Employers only pay a premium, they do not cover the entire cost of health care coverage, and employees who wish to partake in that benefit [yes BENEFIT–as in NOT a requirement] also pay a premium.

If we start doing this for birth control, then we may as well start putting all the cards on the table for health care issues that are preventable [almost completely] with lifestyle change!

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