Quick Hit Ellyn Fortino Tuesday April 9th, 2013, 11:47am

Nearly One Million Illinoisans Eligible For Health Coverage Tax Credits Under The Affordable Care Act

About 957,000 Illinoisans will be eligible for premium tax credits in 2014 that will help them pay for health insurance coverage under the Affordable Care Act, a report released Thursday from Families USA shows.

More than half of the nearly one million people who will qualify have annual incomes between 200 percent and 400 percent of the federal poverty level (or $47,100 to $94,200 for a family of four), allowing the premium tax credits to reach deep into the middle class, said Ron Pollack, executive director of Families USA.

“The tax credit subsidies are a game changer,” Pollack said on a conference call with reporters. “They will make health coverage affordable for huge numbers of uninsured families who would have been priced out of the health coverage and care they need.”

The premium credits will also be of “enormous” help to people who are currently purchasing coverage in the individual market but who are finding it increasingly unaffordable, he added.

The Affordable Care Act, which takes full effect on January 1, 2014, aims to expand health coverage to the uninsured by allowing states to expand their Medicaid programs. It also creates new marketplaces, or exchanges, where people can purchase private health insurance.

Under the law, every state is required to have a new health insurance exchange to help individuals and families find the coverage right for them.

And the tax credit subsidies, which would also start January 1, would allow for those shopping in the marketplace to better afford their coverage. The enrollment process for the premium subsidies begins October of this year.

The study’s 957,000 figure includes Illinoisans currently buying coverage in the individual market and those who are uninsured. People who have insurance with their employer are not factored into the number.

About 85 percent of the people who qualify are from working households and about two-thirds of the people are between the ages of 18 and 54, Pollack said.

The study’s racial breakdown showed 55 percent of those eligible are white, about 24 percent Hispanic and 14 percent black.

Cook County has the largest number of eligible people, coming in at 414,260.

In DuPage County, more than 55,000 people will be eligible and almost 48,000 in Lake County.

In Peoria and Woodford counties, more than 15,000 people qualify.

Jim Duffett, executive director of the Campaign for Better Health Care, called the numbers historic.

“Nearly a million Illinoisans will finally begin to have peace of mind for themselves and their family; that they will be able to access quality health care when [it’s] needed,” he said.

The report comes as members of the Illinois General Assembly continue to work on developing the state’s health insurance exchange.

Pending legislation, SB 34, looks to add some checks and balances on the insurance industry because all the plans sold in the Illinois marketplace are private, Duffett said.

He added that the legislation will help to “level the playing field” in the marketplace for small businesses and individuals, which is crucial if Illinois is to be ready for a state-based health insurance exchange in 2015.

The premium tax credits will be provided on a sliding scale, meaning individuals with lower incomes will receive larger subsides.

Premium subsidies will be paid directly to the insurance company that the individual or family has selected for coverage.

When an insurer gets the proceeds of the tax credit, it means the remaining portion of the premium the individual or family has to pay is greatly diminished, Pollack said.

Pricing is based the Affordable Care Act’s silver plan of coverage and how much it costs in a person’s zip code. Individual income is also considered.

Pollack provided a hypothetical example of a 45-year-old woman, without children, who lives alone and has an annual income of $23,000, which is about 200 percent of the federal poverty level.

In her zip code, hypothetically, the silver reference plan costs $5,000. That would make her out-of-pocket contribution for that premium $121 per month, or $1,450 annually. The remaining portion, $3,550, would be the tax credit premium subsidy.

Chicago resident Ann Battenfield of Chicago is at least one person who said her family would benefit from the credit.

In 2009, she started a small business with her husband, which has been a costly endeavor, she said.

“These tax credits are going to ... reduce our costs by probably close to 60 percent if our income stays as it is now, but we hope that it wont,” Battenfield said. “We hope that our business and income will increase, as it has so far each year, and by 2015 or 2016, I’d hope that we could pay for our own insurance without the tax credits.”

But if they can’t pay on their own, she said, “at least I know that it’s here.”


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