Column on ACA winds down, but coverage of issue far from over

It’s Feb. 15, and that means the Affordable Care Act’s second open-enrollment session closes tonight.

That also makes it the perfect time to end our weekly run of ACA-related columns.

When we started Obamacare Explained in January 2014, readers were inundating the Las Vegas Review-Journal with questions about their enrollment woes and coverage confusion. The column was part myth-buster — we’ve lost count of how many times we’ve had to explain that Obamacare hasn’t touched Medicare benefits — and part consumer advocate. We also tried along the way to explain some of the more confusing provisions in the law, and highlight coverage trends as businesses and consumers adjusted to changing mandates.

But with sign-ups through Nevada Health Link largely going smoothly, and with the clarity that comes with any second go-round, our main purpose — helping people understand and buy their coverage — has been served.

In no way does that mean the Review-Journal is done reporting on the law.

There are plenty of milestones ahead, including a U.S. Supreme Court decision coming in June on who will continue to receive federal tax credits, and full implementation of the employer mandate in January. With a new Congress, there’s also potential for legislative tweaks that could affect the law’s requirements.

As a state-run exchange, Nevada Health Link will have to chart a future in this constantly changing environment. The Review-Journal will be there to chronicle that journey.

Also, we’ll continue to accept any and all consumer questions, and we’ll be happy to help Nevadans track down answers to their questions and concerns. So stay in touch. You just won’t see our guidance in these pages once a week.

So here we go with our final question, which is from Brad of Las Vegas.

Brad is self-employed and bought a 2014 plan through the state exchange when it launched in 2013. Because he’s not salaried, he had to estimate his 2014 income to determine the amount of federal subsidy for which he’d qualify. Problem is, Brad way underestimated his earnings, which came in at a fifth of what he anticipated. Brad’s income was so low that it fell beneath the threshold at which Nevadans qualify for Medicaid.

Even though Brad qualifies based on his 2014 income for Medicaid, he’s not interested in enrolling.

“It really narrows your health care choices, and I do have enough savings to be able to pay subsidized premiums and not be on Medicaid,” he wrote.

But here’s Brad’s problem: Consumers who qualify for Medicaid are ineligible for a federal tax credit to buy insurance. Brad wants to know if he’ll have to repay the subsidy he received to buy private coverage.

We ran Brad’s scenario by insurance brokers and officials with Nevada Health Link, and they agree: He shouldn’t have to repay the subsidy he received. That’s because he “would have been determined ineligible for Medicaid” based on the income he provided at the time he bought, said Tyler Klimas, a spokesman for the exchange.

Added local insurance broker Chris Carothers: “From all of my discussions with state employees in the past, he will be fine and should not expect to pay any tax credit back. I would suspect that he would get a credit.”

Nor is there any harm in setting your estimated income at a higher level to avoid the poverty threshold, said broker Lou Cila. The healthcare.gov application asks how much you expect to earn in 2015, he noted. So the single applicant who writes in an estimate of $16,200 or more, which would let him avoid Medicaid coverage, is not lying, but guessing, he said. Nor is the consumer opening any doors for a higher self-employment tax, because estimates aren’t yet earnings.

Regardless of the case, if a consumer’s income swings more than expected in a given year, he can get into his account via healthcare.gov and revise his stated income. That would change his tax credit on the spot and adjust his premium accordingly, Cila said.

■ We’ll leave you all with a few reminders on what you need to know about enrolling in coverage in coming months.

Open enrollment ends today, but going forward, you can enroll in any off-exchange plan you want. Nevada is the only state that allows consumers to enroll in nonmarketplace coverage outside regular sign-up sessions. Just keep in mind you’ll have a 30-day waiting period before your coverage kicks in.

Also, you can sign up at anytime for a federally subsidized plan through the state exchange if you have a qualifying life event, such as a marriage, divorce, new baby, job transfer or job loss. Again, you’ll have a waiting period of 15 to 45 days, depending on what time of the month you enroll.

The third open-enrollment period, which will allow you to buy subsidized 2016 plans, begins Oct. 15 and runs through Dec. 7.