A draft of the individual application to determine eligibility for health insurance under President Obama’s health reform law has been released by the U.S. Centers for Medicare and Medicaid Services (CMS).
The lengthy application would be used to determine eligibility for health insurance in the private market and from government plans such as Medicaid or the Children’s Health Insurance Program (CHIP), or tax credits.
The 21-page document states on the cover sheet in bold type set apart from the regular text, that an applicant “may qualify for a free or low-cost program even if you earn as much as $92,000 a year (for a family of 4).”
The draft, which fulfills part of the federal Affordable Care Act (ACA), has met with criticism from some, who say that the document is much too large and difficult.
“This lengthy draft application will take a considerable amount of time to fill out and will be difficult for many people to be able to complete,” said Ron Pollack, executive director of Families USA, an advocacy group supporting the health care law, as quoted by the Associated Press. “It does not get you to the selection of a plan.”
Click here to read and download application: CMS Health Insurance Application
Some of the information required and asked in the form include:
- Asking whether the applicant has a parent living outside of their home.
- A separate section for Hispanic/Latinos, asking for ethnicity with choices including Mexican, Mexican American, Chicano/a, Puerto Rican and Cuban.
- Wages and income of all household members, including wages and salaries, retirement funds, capital gains, rental property income and interest income.
- How much the applicant pays in alimony and student loan interest.
- Pregnancy status and if pregnant, how many babies are expected.
- Has the applicant ever lived in foster care.
- Current health insurance information for all family members.
- American Indian and Alaska Native qualifications.
- A section outlining self-employment status, including how to calculate costs of advertising, business rent and license fees into the applicant income statement.
Several government agencies, including the Department of Health and Human Services and the IRS will review applications.
It was not evident if the IRS – which will be responsible for enforcing penalties for non-compliance of the insurance coverage mandate that begins Jan. 1, 2014 – will cross-check income information reported on the federal health application form with income tax statements.