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Collaboration Addresses Insurance Marketplace Issue for Survivors of Abuse

Collaboration Addresses Insurance Marketplace Issue for Survivors of Abuse

April 25, 2014

The Background

The Affordable Care Act offers the potential of helping survivors of domestic abuse in a number of ways. But over the past few months, as the deadline for enrollment approached, survivors attempting to access coverage through the Health Insurance Marketplace were met by an unexpected obstacle: a provision requiring people who were legally married to have filed their taxes jointly, in order to qualify for subsidies.

We know that those subsidies are the lynchpin of the Affordable Care Act; they are the single factor making the law “Affordable” for most people who will enroll through the marketplaces. We also know that there are many reasons why people experiencing domestic violence might live separately from their spouses without filing for a divorce, and those reasons all boil down to safety: people experiencing domestic violence need systems to allow them the flexibility to navigate their individualized circumstances in the way that will keep them the most safe.

Unfortunately, this rule didn’t afford that. Survivors thus were left between a rock and a hard place, unable to access the subsidies they needed to afford the insurance they are required by law to have, due to the abuse that led them to be living separately from their spouse.

The Fix

Thankfully, there is a light at the end of this tunnel! MCEDV has worked with local partner Consumers for Affordable Health Care (CAHC), and with national partners like Futures Without Violence and the National Women’s Law Center, to advocate for changes in the IRS rules that would allow for people experiencing abuse to access subsidies while filing taxes separately. As CAHC explains:

Open enrollment in the new Health Insurance Marketplace (or "Obamacare") officially closed on March 31, 2014, but a "special enrollment period" or extension has been granted to allow certain married people who file taxes seperately and are victims of DV to enroll now. You may be eligible for financial help, including premium tax credits and discounts on cost-sharing (deductibles, co-pays, etc.) but weren't able to enroll in late 2013 or earlier this year because the system did not allow married couples not filing jointly to enroll.  The rules were recently changed to allow married people in an abusive marriage (or other similar circumstances) to enroll and qualify for financial help even if they file separate taxes.  The guidance below is more detailed; people who fall into this category must indicate that they are not married (even if they are) when they apply and enroll by May 31, 2014.

In addition to new coverage options, the ACA requires most people to have health insurance or pay a penalty when they file taxes.  This means that if you don't have coverage when you file your 2014 taxes in 2015, you may need to pay a penalty (or have your refund reduced).  Some people may qualify for an exemption from this requirement for all or part of the year.  Most people who do get exemptions will qualify because they cannot afford insurance but there also exemptions available to people with special or unique circumstances, called a "hardship exemption", including for those who have recently experienced domestic violence. For more information on exemptions, click here: https://www.healthcare.gov/exemptions/

No matter what time of year, you should also check to see if you are eligible for MaineCare or other public programs.  Enrollment in MaineCare is open year-round for those who are eligible, including parents of minor children, children up to age 19, and pregnant women. 

The next open enrollment through the Marketplace will begin November 15, 2014 for plans starting in 2015.

In summary, if you attempted to enroll in through the Health Insurance Marketplace and weren’t able to access coverage because of the way you file you file your taxes, try again. Contact Consumers for Affordable Healthcare; they are experts in navigating the complex world of the Affordable Care Act and can help you get through it, as well. Call their toll-free HelpLine at 1-800-965-7476 or email consumerhealth@mainecahc.org.  Their services are free and confidential.

If you are an advocate or service provider who works with people experiencing abuse, please spread the word to the people with whom you work. This issue is affecting Mainers, and thankfully, there is now a fix. While health insurance might not be at the top of your mind in your line of work, it is important that we help get the word out to people about their options. And time is short; the extension only lasts May 31st.

The Power of Collaboration

MCEDV is particularly grateful for our work with Consumers for Affordable Health Care on this issue. CAHC first brought it to our attention when they saw it playing out amongst their clients. Together, we have gathered and shared information, connected with national partner organizations, educated our federal delegation about the issue… And in the end, succeeded in creating a change that has a real, tangible impact on people’s lives. It is a testament to what we can accomplish when we work together, and energizing to know that while more work around this issue remains to be done, we know we have a strong partnership moving forward.