The recent decision by a panel of three judges from the U.S. Court of Appeals panel in the District of Columbia that the subsidies paid to enrollees through the Federal Exchange (As opposed to the State Exchanges) are illegal would, if it were upheld, make the Affordable Health Care Act an unworkable system. 

The Obama administration has already indicated that they will ask for a review of the decision by the full 11-member appellate court.  Of those eleven, seven were appointed by democrat presidents and of those four were appointed by President Obama. 

Considering that other Federal Courts have ruled on similar motions that it was  the intent of congress in writing the law that giving subsidies through the Federal Exchange and not just the State run exchanges as the law reads is legal.  This would leave us to believe that the full court review will rule in favor of the Obama Administration.

No matter what the ruling is, there will almost certainly be an appeal to the Supreme Court.  It would then be up to the Supreme Court to decide if they would hear the case or let stand the ruling of the lower court.

In the mean time the subsidies will continue for both the state and federal exchanges and it will be business as usual.

For group quotes and information, contact Heather Ainsworth

Do You Like To Shoot?

For those of you in the greater Houston area, AMG is offering you an opportunity to receive free gun or archery range passes.

Many of you know Roy Walters who has been in the insurance industry for many years and his wife Sharon Nash formerly president of Kustom Insurance Markets.  In August they will be opening the G2G Shooting and Archery Range.  G2G is a family oriented shooting and archery range, comfortable and safe for men, women, and children.  The range is located at 25635 Southwest Freeway in Rosenberg Texas.

To help celebrate the opening, from August 1st until December 31, AMG will provide two gun or archery range passes for each issued and paid life application with a minimum premium of $500.00. Submit multiple applications and take your friends and family.

If you want to learn more about G2G, you can contact Roy Walters at roy@g2grange.com. 

For more information on how to obtain your free range pass, contact Steve Gresso at 713.977.0611

What Is Minimum Essential Coverage?

Minimum essential coverage is defined as:

Medicare part A
Medicaid
The Children’s Health Insurance Program (CHIP)
TRICARE and the TRICARE for Life program
The Veterans Health Care Program
The Peace Corps program

Employer-sponsored plans, with respect to any employee, including:

Coverage offered by an employer which is a government plan
Any other plan or coverage offered in the small or large group market within a state
Any plan established by an Indian tribal government
Plans in the individual market
Grandfathered health plans

Any other health benefits coverage, such as a state health benefits risk pool, as recognized by the HHS Secretary in coordination with the Treasury Secretary.

In addition, plans must include essential health benefits, which are items and services within the following ten categories, at a minimum:

Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance use disorder services, including behavioral health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care

Minimum essential coverage does not include health insurance coverage consisting of excepted benefits, such as dental-only coverage.

Certain people will be exempt to the Individual Mandate, including:

Individuals with a religious conscience exemption
Incarcerated individuals
Undocumented aliens and individuals that reside outside of the United States
Individuals who cannot afford coverage (See more details in the question below)
Individuals with a coverage gap of less than three months
Individuals in a hardship situation, as defined by the Department of Health and Human Services
Individuals with income below the tax filing threshold
Members of Indian tribes

What is the penalty for going without minimum essential coverage?

Those who don’t have minimum essential coverage may be required to pay a penalty for each month of noncompliance. The penalty will be calculated as the greater of either:

A percentage of the “applicable income,” defined as the amount by which an individual’s household income exceeds the applicable filing threshold for the applicable tax year or a flat dollar amount.

 The filing threshold comprises the personal exemption amount (doubled for those married filing jointly) plus the standard deduction amount.  The percentage will be 1.0% in 2014, 2.0% in 2015, and 2.5% thereafter.

The annual, flat dollar amount being phased in as follows: $95 in 2014, $325 in 2015, and $695 in 2016 and beyond (adjusted for inflation);
This amount is assessed per each taxpayer and any dependents
The amount is reduced by one-half for dependents under the age of 18
The total family penalty is capped at 300% of the annual flat dollar amount
 

The penalty for noncompliance cannot exceed the national average premium for bronze level-qualified health plans offered through exchanges (for the relevant family size). Any penalty that taxpayers are required to pay for themselves or their dependents must be included in their return for the taxable year. Those individuals who file joint returns are jointly liable for the penalty.
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