Obamacare Forum on Facebook Obamacare Forum on Google Plus Obamacare Forum on Twitter Obamacare Forum on LinkedIn

Greetings Obamacare Debater

It looks like you're new here. If you want to get involved, click one of these buttons!

Sign In with Facebook Sign In with OpenID Sign In with Twitter

In this Discussion

ObamaCare Forums are non-partisan. Ask questions, find information, discuss & debate about the Affordable Care Act, and please remember to follow the forum rules. Please do not debate and provide opinions within discussions in the categories for facts. Thank you for helping to keep these forums informative and constructive.

Disability issue-no health and disability insurance

I have a stepson who is mentally and physically disabled (is in rehab) but has no income and we are paying for all of his expenses (car, rent, therapy, etc.). The issue is whether he would qualify for the Affordable Health care Act as his employer has refused to comply with the state's disability laws which means it will be months before the state responds (we have talked to them many times) and the employer has cancelled his health insurance. The twist here is that he did have income from the employer through basically the first 3 quarters of this year. We are tapped out in terms of our own funds so don't really know what the options are. I'm not even sure if there is any possibility of rental assistance. Thanks.


  • I would think that anyone who is disabled would already be eligible for regular Medicaid (i.e., not the ACA medicaid expansion,)

    I don't understand how his employer not complying with the state's disability laws is pertinent to this.

    Are you saying that he is still employed with that employer and that his employer is dropping coverage for him exclusively, or for everyone employed more than 30 hours a week?  Or is it a former employer, and he was getting COBRA continuation coverage?  If he is working less than 30 hours a week, his employer is under no obligation to offer coverage to him, even if folks who are working more than 30 hours are still getting coverage.

    Regardless, if his employer is dropping coverage, generally, he is eligible for either a subsidy to purchase an individual policy, or to get the Medicaid expansion.  Now, IF his state has a jerk Republican governor/legislature, and the Medicaid expansion was not taken, that is not possible - and also if his income is less than 100% of poverty ($11670/year), then do a a quirk in the legal language, and the fact that the Republicans in Congress are jerks, he is not able to even get that subsidy.

    Now, since he had been working, presumably at a job of at least minimum wage ($7.25/hr), and it would be reasonable to presume that he would be able to work 40 hours per week, he would be well within his legal right to presume that his income will be at a level of 52 x 40 x $7.25, or $15080/yr, in which case he would be eligible for the subsidy.  The fact that he may currently be out of work does not impinge on his legal right to presume that his income going forward in the future will be at that $15080.  All he has to say to say that it is his best estimation that he will get back to work very soon, and working at a full 40 hr/wk schedule.

    I would recommend talking to an ACA navigator (typically the insurance companies selling policies can act as a navigator.

    Now, do not be concerned if it turns out that he does not actually make that $11670 amount.  Even though, looking from the future into the past that he should have presumed a different amount and not gotten a subsidy, the fact that he would have gotten a subsidy does not entail any tax liability.
  • then due to a quirk
  • I am not really sure here, but I would guess that traditional insurance would be the answer here.  That said, I am not sure if there are any provisions in the law that account for situations like this, and I just know that it is frustrating enough having to deal with it without these issues, so I wish you the best.  Thanks for sharing.
Sign In or Register to comment.