by Katherine Restrepo
Director of Health Care Policy, John Locke Foundation
…Until Obamacare begins. On October 1, 2013, the individual insurance exchange markets, another government regulatory body, are scheduled to open for enrollment. It is on these regulated exchanges where individuals may purchase health plans and seek federal subsidies to help offset insurance premium costs. By written text of the law, individuals may only qualify for subsidies on the exchanges in ONLY states that have chosen to establish state-run exchanges. North Carolina is NOT one of these states. Rather, our state has opted for the federal government to deal with the messy task.
This flow chart portrays the many government organizations involved in verifying whether an individual qualifies for federal health insurance subsidies. Now that the employer mandate has been unilaterally postponed, all health insurance reporting requirements by employers are now voluntary until the mandate takes effect in 2015. So, whether or not an employer offers federally qualified health insurance that includes minimum essential benefits, is affordable to employees, and covers 60% of the actuarial value, employees may still receive subsidies on the exchanges — and the IRS will not further verify whether they really are eligible.