Should I put my kids on Medicaid?

October 30, 2014 3:59 PM

Under my current health insurance, I am being forced to switch to a more expensive ACA compliant health insurance plan ...

I would be paying hundreds more per month than before. Based on last year’s ACA application, I am eligible for a heavily subsidized new health plan with much better service, but I would have to enroll my kids in Medicaid. However, because I have a complicated tax situation, my AGI is actually much lower than my actual income. I can afford to pay more for the insurance, but would be paying a lot more for less benefits. Are there any downsides to enrolling the kids in Medicare with the new plan? Would it have any impact on my credit or future financial credibility in any way?

I don’t have strong feelings about taking “government assistance,” although I feel a little uneasy about it. Would there be any reason that I should be wary of taking the Medicaid benefits? Should I just stay with my current plan and pay more? Any other options that I might not be thinking of?

posted by anonymous to Work & Money (10 answers total)

You'll want to look at the networks and see if your kids can see current/future doctors as a Medicaid patient.
posted by Jahaza at 4:14 PM on October 30, 2014 [1 favorite]

My opinion is if you pay the tax, you take the benefit, and I don't necessarily mean only the tax that finances the benefit. If you qualify, take the benefit. They are not going to give you a break on next year's taxes if you don't. The fat cats like nothing better than money from the government.

I don't know a lot about Medicaid. However, the reimbursement rates for doctors are very low. That could make it difficult to find a doc, and you might find a doc who does less than his best (though that's probably rare).

Medicare is administered by the state, so experiences in one state may not apply in another.
posted by SemiSalt at 4:15 PM on October 30, 2014 [1 favorite]

I'm not sure if I have this right. Are you saying that you qualify for medicaid because your income based on taxes is much lower than your actual income, and if you were to do your taxes in a different way you would not qualify? If that is the case I would think you could adjust your reported income such that you would not qualify for medicaid but would qualify for a subsidy for the insurance premium. Does this make sense?
posted by Pembquist at 4:38 PM on October 30, 2014

Your kids getting Medicaid will not have any effect on your credit or financial credibility. It's not like there is something that gets sent around to credit card companies, credit reporting agencies, or anywhere else saying look this person is so broke that their kids get free health care. The only problem might be doctors who refuse to take it.

And please, everyone, let's remember that Medicare and Medicaid are two totally different programs. Medicare is for people 65 and older and is federal, and given regardless of income. Medicaid is run by states and is only for people whose incomes fall below a certain threshold, which, I think, varies by state.

In addition, may states have special programs just for children that are available to working families whose incomes are above the cutoff for Medicaid. I would suggest that you look into the distinctions here. What exactly are they offering you for your kids? And will your preferred pediatrician and other pediatric specialists accept it?
posted by mareli at 5:06 PM on October 30, 2014 [3 favorites]

Your kids' eligibility will depend on your state. Many states expanded Medicaid under the ACA, but many did not, mostly states with Republican governors. This is because the Supreme Court ruling that deemed the ACA was constitutional split their decision with the ruling that expansion of Medicaid was up to each state.

Medicaid is tied to income, and not to credit rating. There is absolutely no link. Depending on where you live it might be challenging to find a pediatrician, but in populated areas pediatricians, in particular, are very Medicaid-friendly. Rural areas with fewer doctors can be more of a challenge, but accessing healthcare in rural areas is a challenge even with insurance; there are just fewer doctors and greater distances involved.

CHIP is also a possibility, and is mostly available to children who are in families where they do not qualify for Medicaid because the family income is above the maximum allowed, but the family income is low enough that free-market insurance is out of reach. My daughter's kids are on CHIP and we consulted a health care accessibility organization where an attorney explained that every child in PA (where we live) is eligible for CHIP, but the premiums are on a scale that slides with family income. This is a godsend for her family, and they have had no difficulty having the insurance accepted by the pediatrician the family chose. Not sure where you live, but if you have problems getting information there may be similar healthcare advocates. They seem to focus on insurance accessibility for children, and I found the lawyer I spoke to (for free) by looking in the yellow pages.
posted by citygirl at 5:34 PM on October 30, 2014

My child is enrolled in our state's CHIP, although due to family income we pay a small premium. The only potential downside is that the network may differ from the one you are currently on, so double check that your child's doctor accepts medicaid.

From my experience in states with Republican lead governments, medicaid for adults mostly sucks and has a significant amount of hassle attached to it to discourage people from signing up or staying enrolled. Conversely, CHIP is generally hassle free and easy. This is probably because the Feds pay an additional 15-23% of CHIP costs vs traditional medicaid so the cost for states is much reduced.

By enrolling your children you will also be doing your part to de-stigmatize safety net benefits and making it harder for ruthless fucks to cut the safety net.
posted by ChrisHartley at 5:58 PM on October 30, 2014 [3 favorites]

We had our son on Medicaid for a year. He qualified, and I feel no guilt about it. That being said, we had a lot of trouble finding decent specialists that accepted Medicaid. When I had the opportunity to move him back to a better health plan, for significantly more money, I did it. Of course he also needed significant abdominal surgery, so the increased cost in premiums paled in comparison to the literally hundreds of thousands of dollars in benefits that Medicaid would never have paid.
posted by Lokheed at 7:00 PM on October 30, 2014

I'm on Medicaid and aside from some complications of figuring out which doctors work--which is really no different than for other insurance--it's been fantastic. It's not a credit thing or anything, it's no different than taking food stamps if you're eligible. Take the programs that are there for you.
posted by Sequence at 8:31 PM on October 30, 2014 [1 favorite]

The government is either telling you to pay more than before or take an option where you pay less. Their options, your choice.
posted by 724A at 8:38 PM on October 30, 2014

My children have been on medicaid since the divorce, 7 years ago. My first choice doctor takes it so we haven't had any problems there. The problems start with the specialist. They don't want medicaid patients. I've had orthopedics be openly rude to me. I've paid out of pocket for the eye doctor and dentist because the ones that I chose did not take medicaid. It's only been this past year that I found a great dentist who happens to take medicaid. Aside from him, the other dentists in my area who accept medicaid are truly horrible.

Medication is a dream, though. I never have to pay anything for my children's medication. Even some OTC stuff is fully covered.

My advice to you is, if your current doctors accept it, then get it. If not, then don't.
posted by myselfasme at 8:58 PM on October 30, 2014