the aca & family law scenarios

The ACA & Family Law Scenarios

Let’s keep the conversation to health

care…• For the most part the ACA does not

affect SNAP/TANF• Questions? The public benefits group at

LAF can help! Email aherzog@lafchicago.org

Meet the Lopez Family• Maria (CP), Juan (NCP) and 4 kids

Maria and Juan’s Incomes• Maria earns $26,000/year • Juan earns $50,000/year• Maria and Juan are uninsured; kids are

on AllKids

Maria is your client• Maria left Juan and took the kids• Domestic violence is involved• What can she do for health care

coverage right now?

Considerations

You file for divorce…• The court orders the parties to submit

a ‘married filing jointly’ tax return until the divorce is finalized instead of individual returns and may find dissipation if a party does not cooperate

Considerations• What happens to Maria’s coverage

options?

Scenario 1 (post divorce)• A court grants the parties children as

tax exemptions in alternate years. Maria plans to keep the kids on AllKids, and plans to get her own health insurance through Medicaid. What are the consequences of alternating the children as tax exemptions?

Considerations• Maria earns $26,000/year• In years where she claims kids, they all

have Medicaid• In years where she does not claim kids,

she earns too much income to qualify for Medicaid and must buy a Marketplace plan for herself• Juan earns $50,000/year so kids can

always stay on AllKids [but the premiums will be higher]

Scenario 2• What if the court orders that Maria

claims 2 kids and Juan claims 2 kids?

Considerations• Maria can always get Medicaid (if her

income stays the same).

Scenario 3• Juan gets a job with health insurance.• Maria has been covering the parties’

children through AllKids. Maria brings a child support action, and the court orders Juan to cover the children through his employer’s health insurance. Court allocates the tax exemptions to Juan.• What are the consequences of

allocating the tax exemptions to Juan?

Considerations• A marketplace plan with APTC is not

available because of MEC • Clients may need to do this research

ahead of time—attorneys may need to ask them to specify what they want in their petition for temp support

Maria still obtains the insurance…

• Maria still obtains All Kids for the children, since she is the custodial parent.• But the cost of the health insurance is

calculated based on Juan’s income, because he is claiming the children as dependents.

Scenario 4 – Post-Judgment

• The judgment specified that Maria and Juan will each claim 2 kids• One of the kids Juan claims, Ramon, is

about to turn 19• Juan has employer insurance• Now that Ramon will be too old for

AllKids, what can he do?

Considerations• Young Adult – up to age 26 rule under the ACA• Need to add provision reserving right to petition the court to maintain a child on parent’s health insurance beyond the age of 19

Scenario 4 – Post-Judgment

• Juan decides to remarry. • His new wife’s name is Sandra. She

also earns $50,000/year.• They will file taxes “married filing

jointly”. • Sandra has no children.

Considerations

Meet the Smith Family

Meet the Smith Family• You are representing Lisa in her divorce

against Sam• They have no children• Sam works and gets health insurance

through his employer.

Scenario 1• Lisa has no employer-provided

insurance• For Lisa to get COBRA through Sam’s

employer (post judgment) she would have to pay $800/month• Lisa has a chronic illness that requires

regular care, visits to specialists, and hospitalization

Considerations• Health considerations• Marketplace insurance

• Family Law Considerations• Legal separation? Pros and cons.• Maintenance to pay COBRA? Taxable to

wife; increases her household income.

Scenario 2• Lisa chooses a Marketplace plan• Lisa applies for Social Security

Disability and is found disabled

Considerations• After 24 month waiting period, she has

to go onto Medicare and off the Marketplace• Cost sharing subsidies might be

available

Meet the Harrison Family• Anna is the CP of their two kids• Bob covers the kids with his employer

insurance

Meet the Harrison Family• Anna files a petition for child support

against Bob. Anna asks the court to NOT order that the children be covered by Bob’s employment-based insurance because she hates the network doctors and the co-pays and prefers to use All Kids.

Scenario 1• The court grants her request and Bob

takes the kids off his health insurance. What are the consequences?

Considerations

Scenario 2• The court tells the parties, “I’m not

going to make taxpayers pay for your kids’ health insurance. Either the kids are covered through NCP’s employer-based health insurance, or you can buy a marketplace plan for the kids.” What are the consequences?

Considerations

Scenario 3• Assume Bob has kids on employer

based health insurance.• The court orders Bob to maintain his

employer-based health insurance for the kids, and tells Anna she can apply for All Kids as a secondary insurer if she wants to. What are the consequences?

Considerations• Unless under 200% FPL, can’t get All

Kids as a secondary

Special Populations• Grandparents raising grandchildren• Same sex couples/families (SEP for

marriage)• Non citizens with citizen children• Others?

Take Away Tips• Tax filing status/rules matter• Education of judges is critical• Uninsured requirement in All Kids

Still have questions?• Contact Dawn Howell at

dhowell@lafchicago.org