On Wednesday, the Supreme Court heard oral arguments for the much anticipated King v. Burwell case, a case that threatens to eliminate tax credits to buy health insurance through the Affordable Care Act (ACA) marketplaces in approximately three dozen states, including Georgia.

Here at GHF, we are happy that the ACA is working and that more than 536,000 Georgians were able to access affordable health care coverage through the Health Insurance Marketplace during the most recent open enrollment period. We look forward to the Supreme Court’s decision in King v. Burwell and hope that it will be a positive outcome for the 461,000 Georgians who currently receive tax credits through the ACA. For now, health care coverage and tax subsidies for Georgia’s consumers remain unchanged.

There has been a lot of news coverage of the case this week and there are many resources available to help advocates communicate about the case to their supporters and stakeholders.

• The Commonwealth Fund has a series of issue briefs about how subsidy shutdowns could affect consumers, health insurers, health care providers, and states. Each comes with a summary infographic.
• The Commonwealth Fund also has an interactive map of the potential impact of a subsidy shutdown on each state.
• Community Catalyst mapped the potential impact by congressional district.
• The Urban Institute has put together a report about the implications of King v. Burwell on uninsured rates, changes in types of coverage, and costs of insurance.

If you are a consumer who enrolled in health insurance through the Marketplace with a tax credit, you likely received a 1095-A form in the mail. You may also have some questions about how to complete the health insurance information on your tax filing form. If your organization works directly with consumers, either providing enrollment assistance or helping them with tax preparation, you may also be hearing about the 1095-A and may have some questions about how health insurance and tax filings intersect. Below is a primer, replete with flow chart, which breaks it all down for you.

Where consumers get their coverage—Marketplace, employer, Medicaid—will determine the impact coverage has on their taxes.  Consumers who have health insurance through their jobs will likely see no changes when they file their taxes – they just check the box on their tax forms indicating they had coverage throughout the year.  The same thing applies to consumers who are covered by Medicaid, Medicare, or their parent’s health plan.  Pretty simple!

During this year’s open enrollment period, 536,929 Georgians purchased health insurance through Healthcare.gov and about 90% received financial assistance to help lower the cost of their premiums.  To keep that tax credit, they’ll have to fill out Form 8962, which asks questions about their health insurance and their income. To help complete that form, all consumers that received a tax credit should have received Form 1095-A in the mail from the Marketplace. Consumers can also find this form on their Healthcare.gov account.

The health insurance tax credit is based on income and household size. When consumers applied for coverage, they estimated their income for the coming year and that amount was used to determine their tax credit. If a consumer misestimated their income, the credit they received may be too high or too low. During the tax filing process, the difference between estimated and actual income is reconciled, and the corresponding tax credit may be adjusted up or down.  This means some consumers may get a refund and some consumers may have to pay back part of their tax credit. If a consumer did not apply for a tax credit previously, they can apply for a credit to be included in their tax refund.

If a consumer went without health care coverage at any point in the year, they may need to fill out an additional Form 8965 to determine whether or not they will need to pay a fine. This year the maximum fee per family will be $285, but fines will increase each year, up to 2% of a person’s annual income.  If a person falls into Georgia’s coverage gap, they will not have to pay the fine, but will need to file the appropriate documents to prove they do not have access to affordable coverage

Household, family, and income changes should be reported throughout the year to Healthcare.gov in order to avoid surprises at tax time.

If you have questions about how your health coverage may affect your taxes, consult a tax professional.  Our partners at Georgia Watch can connect you with free tax preparation help—just click here.

If you have recently gained health insurance through the Health Insurance Marketplace, it may seem like you need to learn a whole new language to understand your coverage. Health insurance can be confusing, especially if you have never had it before or haven’t had it in a while. Just understanding a few key terms, such as premium, deductible and co-pay, will go a long way in helping you use your health insurance effectively. Click here for a simple guide to help you understand your new coverage. Additionally, if you are having trouble using your health insurance you can contact Whitney Griggs, GHF’s Consumer Education Specialist, at wgriggs@healthyfuturega.org or at (404) 567-5016, extension 5.

Open Enrollment has officially ended but some Georgians that missed signing up during the three month period may be able to still get coverage. Those “in line” during this last three days of Open Enrollment who were unable to select a plan due to long call center wait times or technical issues have until Sunday, February 22 to enroll. In this circumstance, coverage will begin March 1^st.  Otherwise, consumers who have a “qualifying event” may be able to get coverage through a Special Enrollment Period. Special Enrollment Periods can occur at any time during the year and are usually triggered by specific events. These events include life changes such as a marriage, birth, change in eligible immigration status and a permanent move. Another type of event that could qualify consumers is a loss of other health coverage. These types of events could include an involuntary loss of employer coverage, loss of Medicaid coverage, and a death or divorce that results in a loss of coverage. In most cases, the Special Enrollment Period lasts for 60 days after the qualifying event occurs. To learn more about what types of events could trigger a Special Enrollment period, click here. If you think you may qualify, visit https://www.healthcare.gov/get-coverage or https://localhelp.healthcare.gov/ to find in-person assistance in your area.

Additionally, the Centers for Medicaid and Medicare Services just announced a Special Enrollment Period for tax season for consumers who were penalized for not having coverage in 2014 and are not currently enrolled in health insurance. To qualify for this Special Enrollment Period consumers must also attest that they were not aware of the penalty for not having health insurance until after the end of Open Enrollment (February 15^th , 2015) because they filed their 2014 tax return after that date. This Special Enrollment Period will begin March 15^th and end April 30^th, 2015. Click here to learn more about the announcement.

Open Enrollment for the Health Insurance Marketplace ended Sunday and more than half a million Georgians enrolled in plans through the Marketplace! Georgia’s enrollment was the fourth highest of states using the Federally Facilitated Marketplace, trailing only behind Texas, Florida, and North Carolina. The state’s enrollment numbers passed the 500,000 mark in large part due to a last minute surge in sign-ups. This year’s enrollment numbers greatly exceed last year’s enrollments of 316, 543. Nationally, 11.4 million Americans selected plans or were automatically re-enrolled through the Marketplace. Click here to learn more about Georgia’s enrollment numbers. For Georgians who begun the enrollment process prior to the deadline but, due to issues with either healthcare.gov or call centers, were unable to complete their enrollment, CMS has extended a Special Enrollment Period (SEP).  These people are “in line” and still eligible to enroll this year.  This SEP will end February 22nd.  If you or someone you know thinks they qualify for this extended enrollment period visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596

On March 4th, the United States Supreme Court will hear oral arguments in King v. Burwell, a lawsuit challenging the tax credits that consumers utilizing the federal Health Insurance Marketplace receive to help make health insurance affordable. Consumers in thirty-four states, including Georgia, use the federal Marketplace to find and enroll in coverage. Nearly nine out of 10 people who enrolled in coverage through healthcare.gov received financial help and paid 75 percent less than the full monthly premium. This has helped bring the nation’s uninsured rate to an historic low.

A study by the Robert Wood Johnson Foundation and the Urban Institute found that the majority of health care consumers who would be impacted and who would likely become uninsured if the tax credits were struck down live in the South. Here in Georgia, hundreds of thousands of people are at risk for becoming uninsured.

We believe there is no legal basis for this challenge and that in June, when a decision comes down, we’ll all breathe a sigh of relief. If the court does, however, strike down the tax credits, such a decision would disproportionately impact the South and would put states like Georgia at a competitive disadvantage by exacerbating existing regional health disparities. If this comes to pass, Georgians for a Healthy Future will advocate for a contingency plan to ensure that Georgians have the same access to tax credits that their counterparts in states like New York, California, Colorado, and Kentucky (states that set up their own health insurance exchanges) have.

Our friends at Families USA have put together a resource page for advocates interested in learning more about King v. Burwell.

What health care rights and protections do legally married same-sex couples have in states like Georgia that don’t currently recognize same-sex marriage?

Can health insurance navigators help consumers find LGBT-friendly plans? (Hint – yes they can!)

How can a consumer file a complaint if they experience discrimination?

What new health care rights and protections do transgender individuals have?

The Affordable Care Act makes health insurance and health care more understandable, more accessible, more affordable, and more comprehensive for Georgians, no matter their gender identity.  Georgians for a Healthy Future and Georgia Equality have teamed up to develop a new set of LGBT specific fact sheets to answer some of these challenging questions that LGBT individuals and families face as they seek out, enroll in, and use their health coverage.

These fact sheets are intended to be a resource for individual consumers and for organizations who represent or provide services tailored to LGBT Georgians. You can view and download these new fact sheets below. If you would like hard copies to distribute to your members, clients, or community partners, please contact Laura Colbert, Georgians for a Healthy Future’s Community Outreach Manager.

Health Insurance Options For Georgia’s LGBT Community

Transgender Health Care

Love and Marriage: Health Insurance Rights for LGBT families

The 2014 Georgia Legislative Session has ended. Thank you to so many of you for reaching out to your legislators during this past session to let them know that covering Georgia’s uninsured and improving access to health care for all Georgians are important priorities for you. Thank you to the dozens of committed advocates who joined us for Cover Georgia day at the Capitol, and thank you to the more than 8,000 of you who signed the Cover Georgia petition to express your support for the Medicaid expansion.

This was a disappointing legislative session for health care consumers. HB 990, which prohibits Medicaid expansion without prior legislative approval, and the portions of HB 707 (amended onto HB 943) that would prevent state entities from serving as health insurance navigators, prohibit the state from setting up a health insurance exchange, and limit the ability of state and local employees to advocate for the Medicaid expansion passed through the General Assembly. While some of the most harmful elements of HB 707 were removed before its final passage, this bill sends a horrible message to Georgia health care consumers who seek information about how to enroll in and utilize the new health insurance options available to them through the Affordable Care Act.

On the upside, hundreds of Georgians are enrolling each day in health insurance. At last count, more than 139,000 Georgians have enrolled in health care coverage through the Health Insurance Marketplace, and Georgians for a Healthy Future is actively working alongside our coalition partners to maximize enrollment leading up to the March 31^st deadline. And despite the setbacks of the 2014 Legislative Session, the Cover Georgia coalition will continue to advocate for covering our state’s uninsured, strengthening our state’s health care delivery system, and growing the economy by implementing the Medicaid expansion.

Thank you again for your continued support and advocacy!

Action Alert—Stop HB 707!

House Bill 707 would prohibit the state of Georgia from leveraging federal dollars to cover the uninsured and from providing consumer assistance to Georgians enrolling in health insurance. HB 707 was designed and promoted by the tea party to prevent hard-working Georgians from accessing health care, and it is in danger of becoming law in Georgia. We need your voice! Georgia citizens deserve better than to have the door slammed in their face when they seek out information about how to cover themselves and their family. Our state’s struggling hospitals and uninsured citizens deserve an honest policy discussion about Medicaid expansion, not a gag order on state and local employees. Call Lt. Governor Casey Cagle at 404-656-5030 and your state senator (locate your state senator here) and ask them to oppose HB 707.

House Bill 707 would:

1. Prohibit any state agency, department or political subdivision from using resources or spending funds to advocate for the expansion of Medicaid. This would stifle conversation and analysis about how to leverage federal dollars from covering the state’s uninsured.

2. Prohibit the state of Georgia from running an insurance exchange or accepting federal dollars related to an exchange. This broad language could stop quality local programs that provide assistance to vulnerable Georgians getting coverage through the exchange.

3. End the University of Georgia Health Navigator Program. Currently, the University of Georgia is providing enrollment assistance to consumers seeking out health insurance with federal grant money. HB 707 would prohibit UGA from sitting down with uninsured consumers and helping them enroll in a private health insurance plan.

4. Prohibit the Commissioner of Insurance from investigating or enforcing any alleged violation of federal health insurance requirements mandated by the Affordable Care Act. Under HB 707, if a consumer has been treated unfairly by their health insurance company, they may have no state recourse.

HB 707 has already passed the state House of Representatives and may be up for a vote in the State Senate early next week. We need your voice to prevent this harmful bill from becoming law!

The following opinion piece by Georgians for a Healthy Future’s Executive Director Cindy Zeldin originally appeared in today’s Atlanta Journal-Constitution.

Large majorities of young adults say they need and value health insurance, yet people in this age group are far more likely to be uninsured than children, seniors or older adults. Thirty-five percent of Georgians between 18 and 34 are uninsured. How can something so important be so elusive?

Until now, the health insurance of millenials had largely been neglected by public policy, leaving them with few options that provided adequate benefits at an affordable cost.

Most Americans get health insurance as a workplace benefit. They get a substantial employer contribution and receive these benefits on a pre-tax basis. Today’s young adults, however, are entering the job market in a tough economy. They are less likely to land jobs with health insurance. They often cobble together internships and part-time work to gain experience and make ends meet. For too many young adults, there simply has been no viable pathway to coverage.

The tide is turning. An estimated 3.1 million young adults nationwide — and 123,000 here in Georgia — have gained coverage as a direct result of an Affordable Care Act provision that allows parents to keep their children on policies up to age 26. This popular and effective public policy change was just a first step. The new health insurance exchanges will provide options for young adults who previously had nowhere to go.

These plans provide decent benefits and, in many cases, access to tax credits to make them affordable. The tax credits, available to individuals with annual incomes between $11,490 and $45,960, can be taken either at the time health insurance is purchased or at tax time. Some moderate-income individuals also can get help with out-of-pocket expenses.

For millenials who had been underwhelmed with the health insurance options available to them in the past, this is a breath of fresh air. For example, maternity coverage had been nearly impossible to secure in the Georgia non-group market for young couples ready to start a family. Now, this important benefit will be available.

While it is true some young adults enrolled in old plans may see higher premiums, many of those old plans didn’t provide adequate protection. Further, young adults who had a pre-existing chronic helath condition were locked out of the market entirely, a practice insurance companies must discontinue.

 The private insurance plans available through the exchanges won’t meet the needs of all young adults in Georgia. Those who have incomes that place them below the poverty line will likely remain uninsured unless Georgia expands its Medicaid program.

Most young adults want what Americans of all ages want: the peace of mind that comes with knowing that an unexpected cancer diagnosis or accident doesn’t equal financial ruin, and that they have access to basic medical services. The new coverage options are finally leveling the playing field for this generation. It’s about time.