Cobbling together quasi coverage

In comments, PowerMAD asks a good question about the risks of running naked:

What are the consequences (beyond the obvious gambling that nothing’s going to happen) of dropping health insurance for Nov/Dec, with the plan to re-up for January? I’m about to turn 61, unable to get a full-time job that pays anywhere near what I need to get by, so struggling to make it as a freelancer. My health is okay. Husband is about to turn 53, but he’s got some problems – nothing life threatening, but semi-chronic. A major client of mine has dried up w/o warning; I’ve got a couple new ones in the pipeline, but won’t be generating actual income until January.

There are a lot of things to untangle. First, a scenario of significantly variable income is an excellent reason to buy insurance on Exchange. When times are good the advanced premium tax credit might be either very small or nil. However if there is an unexpected income drop, the advanved premium tax credit can be updated for the following month once the new income information is entered.

At the age of the couple, I would be terrified about running naked for two months but when there are no good options, bad options are the only ones to choose from. I am assuming they had coverage since January 1. That means they would have had ten months out of twelve with qualified coverage. The mandate penalty only kicks in if there is a gap of at least three months. The mandate will not apply in this scenario.

Now what are the options that are possible to provide at least the semblence of coverage?

First, I would check out Medicaid eligibility. I don’t think that will be a viable option but it is worth ten minutes.

Secondly, in the ACA, there is a three month grace period for non-payment of premiums after the first premium of the policy period is paid to effectuaatte the policy. It is effectively a floating one way option for people in this situation (it has some policy implications but we’ll ignore those today).

If they do not pay the November premium, the insurer is still on the hook for the first thirty days worth of charges. The insurer can go back for the unpaid premium debt and any cost sharing that would have been incurred from any services. Now let’s assume that the December premium is also not paid. At that point, the providers eat the cost. The insurer now holds two months of premiums and any potential cost sharing as a bad debt that it can collect on. once the insurer gets paid and the account is brought back to current, the providers will get paid. Due to the time of the year, the policy is then terminated on December 31, 2016 and a new policy is needed for January 1, 2017 but in other times of the year, this implicit option can go for three months instead of two months.

The problem then becomes January coverage as a new policy is needed and it does not go into effect until the first premium is paid. I don’t have a good hack or exploit for that. February coverage, given the details is simpler, a policy could be bought in early January and paid for in late January and things go back to the way they were.

I Didn’t Know It Was Going to Be THAT Kind of Calendar

Or I might have had second thoughts:


Send them to

Road to Nowhere

Long day, and was relaxing in the Lazyboy when I pulled a muscle in my neck/back.

While sitting in a lazyboy.

After 40, the only real mystery left is what is going to kill you…

Old People Suck, But Not As Much as the Professional Left

Svensker asks:

Can we somehow combine the Hatin’ on Boomers thread with the Hatin’ on Disgruntled Progressives thread? Cuz that would really cause tempers to flare and I wanna watch.

You know who really suck? Old members of the professional left. Splitters.

Consider this an open thread.

Like Small, Wet, Salty Badges of Emotional Truth

Day three of America being held hostage by hurt feelings- checked memeorandum, and sure enough, fee-fees lead the day. I’ve obtained this insider video of the professional left visiting the beach:

I’m swamped today so I figured I would fire shit up right off the bat.

Smedley Butler Rides Again?

Ryan D’Agostino at Esquire has an article wherein ex-Congressman Eric Massa alleges a vast conspiracy to destroy his credibility, because… well…

… The conference-room door closed, the congressman stirred his coffee and then folded his hands on the table before him, paused for a dramatic moment before beginning to speak. “Gentlemen, what we have here is a constitutional crisis,” he said. “If what I’ve been told is true — and I believe it is — General David Petraeus, a commander with soldiers deployed in two theaters of war, has had multiple meetings with Dick Cheney, the former vice-president of the United States, to discuss Petraeus’s candidacy for the Republican nomination for the presidency. And in fact, that’s more than a constitutional crisis. That’s treason.”
One month before, in early January, Congressman Massa had called me and sketched out the bare bones of the tale he was now propounding. Four retired generals, he said — “three four-stars and one three-star” — had picked up disturbing reports that Petraeus, the commander of United States Central Command, whose portfolio contains the worst trouble spots on the globe, including Iraq and Afghanistan, had recently met with Cheney — twice — and Cheney was trying to recruit him to run in 2012. Were he to be the nominee, Massa said, Petraeus would be in the unprecedented position of a military man running for president against his own commander in chief.
“We have to see this for what it is,” Massa said, his voice pleading. “There is a reason that we have in this country civilian leadership of the military. It is, among other things, to avoid something like this. Because in order to succeed electorally, General Petraeus must fail militarily. You understand? In order to succeed electorally, he must fail in his mission. Were he to run and win — and if he were to run, he would win in a landslide — we would be witness to an American coup d’état. It is the functional equivalent of the political overthrow of the commander in chief.”
The congressman was beside himself. And although we did not come to agreement on how best to describe the implications of such high-stakes, high-level skulduggery, he did manage to impress upon the small group in the soundproof conference room of the midtown high-rise that if the general and the vice-president were indeed hatching such a plot, it was a serious matter indeed.
He also managed to impress upon us something else: Congressman Eric Massa was a little bit crazy.
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Sunday Night Open Thread

Pacific and Treme.