Obamacare: Who qualifies for AHCCCS/Medicaid?

Medicaid in Arizona is knows as AHCCCS (pronounced “access”). That stands for the “Arizona Health Care Cost Containment System”.  Arizona is expanding AHCCCS enrollments under Obamacare by raising income limits to 133% of the federal poverty level.  That’s $15,282 per year for an individual, $20,628 for a family of two, and $25,975 for a family of three.

People enrolled in AHCCCS are assigned a health insurance plan that is an HMO network. AHCCCS health plans have pretty large networks of doctors and hospitals throughout Arizona. These are just like a regular health insurance plans, except they have no co-pays, or very limited co-pays for services.

I have talked to a few people who would qualify for AHCCCS, but they told me they don’t want to be on Medicaid because they think it is for poor people and doctors will not want to treat them.

I have also talked to two different people who are self-employed and who, based on their income tax returns, would qualify for AHCCCS. But they do not think they deserve to get health insurance for free and have no co-pays for their health care. They want to buy their health insurance through the Exchange. They welcome the idea of getting a subsidy, but they want to pay something for their health insurance!

A woman I talked to yesterday said she got through the healthcare.gov process, but has not yet picked a plan – and she may not be able to pick a plan. That’s because, when her IRS record was checked, she got a notification on her account that she qualifies for AHCCCS.  She estimated her 2014 income will be over $25,000 and she doesn’t think she qualifies for AHCCCS – and she doesn’t want AHCCCS.

She called the 800 number for healthcare.gov and was told that application assisters at that level cannot make the change she needs to her account.  She was told she will get a call from someone who can help her.  I told her she’d better not count on getting that call, and I would be amazed (and really impressed) if she gets such a call.  In the meantime, the December 23rd deadline is approaching and she needs coverage for January 1st.

I’ve sent a couple of emails to people who work for CMS. Hopefully, there is somebody out there who knows how to address this issue for people who do not want Medicaid, but whose tax records say they should not be able to buy their own health insurance and pay something for it.

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