As income taxes are filed, half who got Obamacare subsidy will have to pay part of it back; almost as many will get a refund

By Melissa Patrick
Kentucky Health News

This week will go down in history as the first time the Internal Revenue Service enforced the Patient Protection and Affordable Care Act's tax penalty for those who can afford insurance but didn't buy it.

The penalty for those who don't qualify for an exemption is $95 per adult and $47.50 per child, or 1 percent of your income, whichever is larger. The penalty will increase next year to the greater of $325 per adult or 2 percent of household income.

"Ever since its passage, the mandate that every American have health insurance has been at the heart of the controversy over the ACA," Elaine Kamarck writes for the Brookings Institution. It was an issue long before the law passed; in the 2008 presidential primaries, Hillary Clinton favored it and Barack Obama opposed it; as president, he changed his mind.

Tens of thousands of Kentuckians who got subsidies to help pay for their health insurance through the Kynect exchange will probably be surprised to find that they will have to repay some of the subsidy, or that they will get a refund, depending on the difference in their actual income level and the income that was recorded at the time they bought insurance. Most incomes were likely based on an estimated income for the year. Generally, if you overestimated your 2014 income, you will get a refund. If you underestimated it, you will have to repay some or all of the subsidy, which was subtracted from the "sticker price" of insurance to calculate your premium.

Infographic from Kaiser Family Foundation

A study by the Kaiser Family Foundation estimates that 50 percent of Americans who got 2014 tax subsidy will owe some money, and 45 percent will receive a refund. The foundation estimates the average repayment will be $794 and the estimated average refund to be $773.

Some reasons for the income differences are getting a raise, losing a job, and working a different number of hours; and non-job factors such as a change in family size as a result of births, deaths or divorce. These changes should be reported when they occur, so subsidies can be modified, but often aren't, says the Kaiser Family Foundation.

John Ydstie of NPR reports some real examples of policyholders facing these surprises. He tells the story of one person who makes $30,000 a year who decided to take less than her estimated $250-a-month premium subsidy because of her uncertainty about the program, and is getting a $3,900 refund. He notes that most people on Obamacare can't afford to do this.

Ydstie also tells the story of a young woman whose monthly subsidy dropped to $60 from $250 after she married her longtime partner in 2014 and their combined incomes bumped them into a different category. They have to pay back $1,800 but are hoping the amount will be adjusted to $400, to apply only to the months they were married; this has not yet been determined.

As the IRS implements the law, it is faced with budget, staffing, and operational cuts, Kamarck writes: "Given the staff limitations of the IRS and the complexity of reporting and reconciling the government subsidies in the law with people’s income there is likely to be confusion, frustration and, most importantly, a lot of people who find out that their tax refund is a great deal smaller than they anticipated." She suggests that the IRS, in order to survive the first tax season with the ACA, "give taxpayers a break whenever it can."

As tax deadline nears, most uninsured appear likely to choose penalty; some with coverage are having to refund part of subsidy

Kentucky Health News

Most people facing a tax penalty for not having health insurance appear likely to pay it instead of taking advantage of a special opportunity to but coverage and minimize the penalty.

"Major tax-preparation firms say many customers are paying the penalty and not getting health insurance," reports Stephanie Armour of The Wall Street Journal. "Research also suggests that many people who lack health insurance will pay the penalty and not get covered this year."

Many polls have found that many if not most people without health insurance are unaware that they are subject to a tax penalty under the federal health-reform law. That percentage appears to be declining as they prepare their income-tax returns, but a poll taken in late February found that when told of the penalty, only 12 percent of the uninsured said they would get coverage.

For many people, the choice is simply financial, since coverage for them would be more expensive than the penalty -- 1 percent of their income, or $95 per adult or $47.50 per child, whichever is larger. Others say they don't need coverage, and some object to the penalty or the law altogether.

The penalty will increase to 2 percent of income and $325 per adult or $167.50 per child for the 2015 tax year, so if you are uninsured and don't qualify for Medicaid or one of the law's exemptions, the end of the special enrollment period, April 30, is the last chance to avoid that penalty.

"In late February, H & R Block reported that its uninsured clients had paid an average penalty of $172," reports Abby Goodnough of The New York Times. "The money comes out of refunds, while people who do not get refunds are required to pay the Internal Revenue Service by April 15."

Some people who have coverage "might find another unpleasant surprise: As many as half the nearly 7 million Americans who got subsidies to offset their premiums may have to refund money to the government, according to an estimate by H & R Block," the Journal reports. "The subsidies are based on consumers’ own projections of their 2014 income, but some estimated incorrectly and received overly generous credits. Those people will see smaller-than-expected refunds or could owe the government money."

"H & R Block also found that as of Feb. 24, just over half of its clients with subsidized marketplace coverage had to repay a portion of their subsidy because their 2014 income turned out to be higher than what they estimated when they applied for coverage," the Times reports. "The process includes "new forms that even seasoned preparers are finding confusing."

The Obama administration announced last month that 800,000 people with insurance bought under the reform law had received incorrect information needed for their tax returns. About 10 percent of them have still not received corrected forms, it announced Friday. "The administration said people who have not received the corrected forms do not have to wait to file their taxes and will not have to pay any additional tax due to the effort," The Hill reports.

The Wall Street Journal reports, "Consumers who already filed their tax returns using the incorrect forms provided though state or federal exchanges won’t be required to file amended forms, and the Internal Revenue Service won’t assess additional taxes, said Mark Mazur, the Treasury Department’s assistant secretary for tax policy."

Kentuckians split on taxing sugary drinks to pay for nutrition and physical-activity programs, but like warning labels for such drinks

Should soda and other sugary drinks be taxed to fund school nutrition and physical activity programs? Kentucky adults are almost evenly divided on the issue, but the majority of them believe that sodas and sugary drinks should come with a health warning label.

According to the latest Kentucky Health Issues Poll, 51 percent of Kentucky adults support taxing soda and other sugary drinks, while 47 percent do not. Fifty-five percent of women favored the measure, while 46 percent of men favored it. African American adults (67 percent) were more likely than white adults (50 percent) to support a tax. Sixty-eight percent of respondents ages 18-29 favored the measure, 49 percent of those 30 to 45, 49 percent of those 46 to 64 and 32 percent of those 65 and over.

The poll also asked respondents if sodas and other sugary drinks should come with a label that says "studies show that daily consumption of soda and other sugary drinks contributes to diabetes, obesity and tooth decay." Seventy-one percent of Kentucky adults favored adding the label.

A random sample of 1,597 Kentucky adults were interviewed by phone. To see the rest of the results, click here. The poll is sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati.

Kynect opens special enrollment period March 2-April 30 to give people without health insurance a chance to avoid tax penalty

The state health-insurance exchange, Kynect, is reopening enrollment in March and April to allow signups by Kentuckians who discovered that not having health insurance means they have to pay a federal tax penalty.

“We believe that many Kentuckians did not realize those who do not obtain health coverage could face significant penalties when they file their taxes,” Gov. Steve Beshear said in a news release. And given that the personal risks of not having health coverage are even greater than the penalties, we have decided to continue a special enrollment period to allow those individuals more time to sign up.”

The penalty for not having health coverage last year is 1 percent of income, or $95 for each adult in the household and $47.50 for each child, whichever is greater. For 2015, the penalty will be 2 percent or $325 for each adult and $167.50 for each child.

"Individuals taking advantage of this special enrollment period will still owe a fee for any months they were uninsured and did not qualify for an exemption in 2014 and 2015," the news release warns. "This special enrollment period is designed to allow such individuals the opportunity to get covered for the remainder of the year and avoid additional fees for 2015."

If your household income is between 100 and 138 percent of the federal poverty level, which makes you eligible for expanded Medicaid, you will still be charged a penalty if you don't sign up. Medicaid enrollment is open year-round, but the special enrollment for private insurance will end April 30.

Visit https://kynect.ky.gov or call 1-855-4kynect (459-6328) to learn more.

Obamacare deadline is extended for those who had technical problems; state may also extend it for those facing a tax penalty

Were you unable to sign up for Kynect health insurance by the Sunday deadline because of technical problems? You now have until Feb. 28 to sign up. "And like other states and the federal government, Kentucky officials are also considering a 'special enrollment period' for those who find out at tax time that they’ll have to pay a penalty if they’re not insured," Laura Ungar reports for The Courier-Journal.

Kynect Executive Director Carrie Banahan said Kentuckians who experienced technical problems and believe they qualify for an extension should contact the Kynect call center at 855-459-6328. Ungar explains, "The Saturday outage of an Internal Revenue Service function for Obamacare enrollment prevented some people from getting their income verified so they could enroll on HealthCare.gov," the federal website used in most other states.

"Officials with the federal government and several other states said they saw a surge similar to what Kentucky experienced in the final days of enrollment — partly from people who realized for the first time they would face an IRS penalty at tax time," Ungar reports. The penalty for not having coverage in 2014 is 1 percent of annual household income, or $95 per adult and $47.50 per child, whichever is higher. Not having coverage in 2015 will incur a penalty of 2 percent, or $325 per adult or $167.50 per child, whichever is more.

Feb. 15 is deadline to get health insurance; those who don't can be penalized up to 2 percent of their annual income

Sunday, Feb. 15 at 11:59 p.m. is the deadline to buy private, subsidized health insurance through Kynect, the state-run marketplace created under federal health reform.

If your annual income is above the federal poverty level and you don't buy a policy or enroll in Medicaid, and don't qualify for one of several narrow exceptions, you will be subject to a tax penalty from the Internal Revenue Service. (You may qualify for Medicaid if your income is less than 138 percent of the poverty level; Medicaid enrollment is open year-round.)

The penalty is $325 per person or 2 percent of household income, whichever is greater. "In many cases, this penalty could exceed the annual cost of insurance," the release said, giving these examples using "bronze" plans (the cheapest alternative, which has high deductibles):

• A 30-year-old in Lexington making $20,000 would qualify for a subsidy and pay $37.44 for a full year of bronze coverage, or pay a $400 penalty and remain uninsured
• A 25-year-old in Louisville making $40,000 would qualify for a subsidy and pay $604.08 for a full year of bronze coverage, or pay an $800 penalty and remain uninsured.

“Not only is insurance important for your physical health, it also makes financial sense,” Kynect Executive Director Carrie Banahan said in the release. “Why risk the possibility of being uninsured and facing a costly medical procedure and a tax penalty, especially when you may qualify for financial assistance to defray some of your premium cost? Don’t wait. Visit Kynect and enroll in healthcare coverage today.”

Private insurance on Kynect is subsidized by an advanced premium tax credit. Those who qualified for the credit will receive a 1095-A tax form, which provides information to help fill out Form 8962 as part of their federal tax returns. Individuals with questions about their Form 1095-A can call a special Kynect hotline at 1-844-373-2417. More information is available at kynect.ky.gov.

People on Medicaid, Medicare, the Kentucky Children's Health Insurance Program, catastrophic health insurance or insurance through an employer or other agency do not need Form 1095-A to file their federal taxes.

Kynect private-insurance enrollment runs through Feb. 15; exchange works to get taxpayers information to prove coverage

With the close of open enrollment coming Feb. 15, state officials are making a final push to get Kentuckians to enroll in Medicaid or buy private, subsidized health insurance on the state's health benefits exchange, Kynect.

The federal health reform law requires most people to have health insurance or pay a penalty, and Kynect says it is working to help Kentuckians get the information they need to prove coverage when they file their tax returns.

Outreach events continue at several campuses in the Kentucky Community and Technical College System. Events are open to the general public and will feature "Kynectors" who answer questions and help people find a plan that fits their needs and budgets. Tthe remaining events will be at:

• Bluegrass Community and Technical College, Leestown and Newtown campuses, 10 a.m.–2 p.m., Feb. 2 and 3.
• Jefferson Community and Technical College, downtown Louisville campus, 10 a.m.–2 p.m., Feb. 4 and 5.
• Gateway Community and Technical College, Covington campus (Two Rivers Building), 10 a.m.–2 p.m., Feb. 9 and 10.
• Gateway Community and Technical College, Boone County campus, 10 a.m.–2 p.m., Feb. 11 and 12.

As of 3:30 p.m. Jan. 29, 50,754 new applications for coverage had been submitted to Kynect; 43,181 people had been newly enrolled in Medicaid; 75,760 people had renewed their private insurance; 18,533 had newly enrolled in a private plan; and 4,914 individuals had enrolled in dental plans.

Kynect Director Carrie Banahan said, “If you or anyone you know remains without health insurance the time to enroll in coverage through Kynect is now. Please don’t delay. Enroll as soon as possible.”

Those who need health insurance are encouraged to log on to www.Kynect.ky.gov, call 1-855-4kynect (459-6328), or contact an insurance agent or Kynector before the Feb. 15 deadline. Medicaid enrollment is open year-round.

Taxpayers, take note

Individuals who qualified for an advanced premium tax credit, or subsidy, through Kynect will receive a 1095-A tax form in the mail. The form provides information for individuals and families who received payment assistance to help them fill out IRS Form 8962 as part of their federal return.

"Kynect has instituted a robust training and information program to help individuals, Kynectors, insurance agents and tax preparers understand the requirements," a state press release said. "Individuals with questions about their Form 1095-A may also call a special Kynect hotline at 1-844-373-2417.

Individuals with Medicaid, KCHIP, Medicare, catastrophic health insurance or insurance through an employer or other agency do not need Form 1095-A to file their federal income taxes. 

1/4 of Ky. adults say they have tried e-cigs; just over half of adults (but not the e-cig users) want them taxed and regulated

More than four in 10 Kentucky adults under age 30 have tried electronic cigarettes, and the older and better off economically Kentuckians are, the less likely they are to have tried them. Overall, one-fourth of Kentucky adults and 60 percent of current smokers have tried the devices.

Those are major findings of the latest Kentucky Health Issues Poll, which also found that 61 percent Kentucky adults want the U.S. Food and Drug Administration to regulate e-cigarettes and 53 percent want them to be taxed in the same way as traditional cigarettes.

The poll, taken Oct. 8-Nov. 6, has an error margin of plus or minus 2.5 percentage points. It was conducted by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,597 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones.

The poll was conducted for the Foundation for a Healthy Kentucky and the Cincinnati-based Interact for Health nonprofit. “Last year, Kentucky became one of dozens of states to prohibit the sale of electronic cigarettes to minors,” Susan Zepeda, president and CEO of the foundation, noted in a news release.

The poll didn't ask respondents if they were currently using e-cigarettes, but the data offer some interesting details: Men (29%) were more likely than women (20%) to have used an e-cigarette, and college graduates (14%) and were less likely than others (27%) to have done so. So were residents of the Lexington area, at 16%. Among those who said they previously smoked cigarettes, 19 percent said they had tried the electronic version.

As might be expected, current smokers those who had used an e-cigarette were much less likely to say the devices should be taxed like tobacco cigarettes.

Penalty for those without health insurance in 2015 will be significantly higher than for 2014; Feb. 15 is deadline to sign up

Wall Street Journal photo illustration

One aspect of the Patient Protection and Affordable Care Act supporters don't spend much time talking about is the part of the law that imposes a penalty on those who don't have insurance, but the time has come for the uninsured to pay up.

This is the first year taxpayers are required to report to the Internal Revenue Service whether they have health insurance, and charged a fine if they don't, as required by the federal health care law.

This year's fine is $95 per adult or 1 percent of the household income, whichever is greater. This fine will increase significantly in 2015 to $325 per adult or 2 percent of household income, whichever is greater. And will increase again in 2016 to $695 per adult or 2.5 percent of income, whichever is greater.

Dayna Dayson of Phoenix, Ariz., estimates that she’ll have to pay $290 in fines this year when she files her federal return, Ricardo Alonso-Zaldivar reports for The Associated Press. Dayson, who’s in her early 30s and works in marketing, said she would like to have health insurance, as required by the law, but can't afford it.

“It’s touted as this amazing thing, but right now, for me, it doesn't fit into my budget,” she told AP.

It is too late to avoid this year's penalty, unless you qualify for one of about 30 exemptions, most of which are related to financial hardships, Alonso-Zaldivar notes, but you can avoid a penalty next year if you sign up for health coverage by Feb. 15, the last day of open enrollment.

Kentuckians can sign up for health insurance through Kynect, the state's health insurance exchange. Jan. 15 is the deadline to get covered by Feb. 1 and those who sign up by Feb. 15, the final enrollment deadline for 2015, will get coverage beginning March 1. Medicaid enrollment is open year-round.

"Roughly 4 million uninsured people will pay penalties and 26 million will qualify for exemptions from the list of more than 30 waivers," H&R Block says in a congressional analysis, Alonso-Zaldivar reports.

One reason many of the uninsured will end up paying a 2015 fine is that they don't know about the larger fine or the sign-up deadline to avoid this penalty.

Only 3 percent of uninsured people know what the fine for 2015 will be, according to a recent poll by the Kaiser Family Foundation. And just 5 percent of uninsured people know the correct deadline, according to a Kaiser poll, Alonso-Zaldivar reports.

“We could be looking at a real train wreck after Feb. 15,” Stan Dorn, a health policy expert at the nonpartisan Urban Institute, told AP. “People will file their tax returns and learn they are subject to a much larger penalty for 2015, and they can do absolutely nothing to avoid that.”

Alonso-Zaldivar suggests one reason people don't know about the penalties could be because they are the "most unpopular part of the health care law" and supporters have "played down the penalties in their sign-up campaigns" to avoid "political backlash."

If you are interested in estimating your potential fine or seeing if you qualify for an exemption, Alonso-Zaldivar suggest going online and using the Tax Policy Center’s Affordable Care Act penalty calculator or using a free online tool called “Exemption Check" created by TurboTax.

While many, like Dayson, find paying for health insurance "doesn't fit into the budget," one way to save money when choosing a plan is to make sure you choose a plan with the best deductible option for your family, Michelle Andrews reports for Kaiser Health News.

Typical plans have a single out-of-pocket deductible that must be met for the entire family before insurance will start paying. But some plans offer both a total family deductible and a separate deductible for each family member. For example, a $3,000 deductible family plan might have separate $1,000 deductibles for each family member, Andrews reports.

This type of plan is a good option if one family member requires more medical care than the others over the course of the year, Sabrina Corlette, project director at Georgetown University's Center on Health Insurance Reforms, told Andrews.

This plan allows the insurance company to start paying for all of this one family member's medical bills after their embedded-individual-deductible is met, even if the family has not reached its total out-of pocket payment, Andrews writes.

You might have to call the plan directly to see if it offers this type of deductible, Corlette said.

Reform law's backers say it boosts economy by freeing 'job lock;' foes cite estimate that it will make some drop out of job market

As the Patient Protection and Affordable Care Act's second enrollment period gets underway, supporters of the law say it boosts the economy by creating an affordable, accessible insurance market that's not dependent on employer-based insurance.

Travis Kalanick, co-founder of Uber, said the law has been "huge" for his personal-transportation business. Uber's drivers are independent contractors, so the company does not provide them with health insurance. But because the ACA creates a functioning individual market for health insurance, making it easier and more affordable for Uber drivers and others to buy coverage on their own, Americans don't have to stay in a job just to keep their health insurance.

"The democratization of those types of benefits allow people to have more flexible ways to make a living,” Kalanick said during dinner for reporters, according to Buzzfeed. “They don’t have to be working for The Man.”

This is why Uber loves Obamacare, reports Jason Millman of The Washington Post. For a company like Uber, it's about liberalizing the workforce so that people are able to take jobs they do like that don't provide health care, he writes.

Numerous sources cite the ability of individuals to obtain affordable coverage outside of the workplace as a boon to the labor market. A Congressional Budget Office analysis earlier this year said giving families more options for obtaining affordable health insurance outside the workplace, the PPACA removes a barrier to job mobility and boosts the economy.

Before the PPACA, many Americans’ only source of secure health-insurance coverage was through their jobs because without work-based plans, people often found coverage to be too expensive or impossible to obtain due to pre-existing conditions. This created a health-insurance obstacle to labor mobility, which is sometimes called "job lock", writes the Jason Furman in an online post from the White House Council of Economic Advisers.

Job lock can prevent individuals who want to look for a better job, change careers or start a new business from doing so for fear of not having health coverage, the CBO said. Now, because of both the PPACA’s patient protection measures and ban on discrimination against people with pre-existing conditions, Americans have reliable access to health insurance without having to count on employers to provide it, says the report. CBO also said many Americans will be able to start small businesses or take new positions where they can be more productive because they don't have to worry about health insurance.

Opponents of the law argue that it shrinks the labor market. For example, in a Forbes article, Avik Roy writes that the law hampers job growth by imposing one of the largest tax hikes in U.S. history, increasing the cost of employing workers and establishing exchange subsidies that encourage workers to drop out of the job market. They cite a CBO estimated that by 2024, 2.5 million full-time-equivalent workers will drop out of the job market. Jay Carney, then White House press secretary, celebrated the findings, arguing that they mean that Americans would no longer be “trapped in a job,” Roy writes.

Kynect enrollment for private, subsidized insurance reopens; previous enrollees should check website and re-enroll

By Molly Burchett
Kentucky Health News

The Patient Protection and Affordable Care Act's second annual open enrollment period has started and brings with it many changes.

Kentuckians can use Kynect, the state’s health insurance exchange, to purchase their plans. They can also use Kynect to sign up for Medicaid, if they qualify. During the first open enrollment period under the 2010 federal law, more than 521,000 people obtained coverage through Kynect.

About 85,000 of them purchased private insurance plans, and most of those received a federal subsidy. The rest were added to Medicaid, the government health insurance program for the poor and disabled.

People who have been added to Medicaid do not need to sign up again, but should report income changes to the managed-care organization that handles their coverage. They can change their MCO until Dec. 12.

Even those who purchased plans through Kynect last year should re-enroll and consider purchasing a different plan this year because plans have changed, new plans are being offered and there have been changes in the factors used to calculate premiums and subsidies. The penalty for individuals without health coverage in 2015 will be $325 per adult or 2 percent of household income, whichever is greater. That's going to be more of sting than this year's $95-or-1 percent penalty.

Health plans will send a new tax document, IRS Form 1095-B, to policyholders to document 2014 coverage. While some exemptions are available for a short lapse of coverage up to 3 months, most taxpayers without coverage must pay the 2014 penalty and will get a taste of the higher penalties to come.

Plans on Kynect still vary widely. In addition to comparing premiums, it is important to consider deductibles, co-payments and other plan details. Kynect offers four basic types, labeled bronze, silver, gold and platinum. Bronze plans have the lowest premiums but have the highest deductible. As you move up the plan spectrum to platinum, your premiums increase and your deductibles decrease. The exchange also offers people under 30 a plan that provides only catastrophic coverage with a very high deductible and no subsidy.

Expect premium and plan changes

Premium increases in 2015 are likely for most Kentuckians, but some premiums could decline slightly. Rate filings indicate plans with Kentucky Health Cooperative could increase an average of 20 percent, while plans with Humana could increase an average of 12.8 percent. The tax-credit subsidy available to people with incomes between 100 and 400 percent of the federal poverty level ($11,670 to $46,680 for an individual) reduced the effect of premium increases.

Buyers should be watch for changes in plans because subsidies are based on the second-lowest-cost plan, silver, and many of these plans have changed in 2015. When that happens, people may face substantial premium increases unless they take the time to shop and make sure they’re still in a low-cost plan.

Fortunately, this year the actual cost of health insurance this year will be displayed on Kynect, giving insurance-browsers both the basic premium cost and the subsidy before completing an application. Enrollees can also complete a preliminary eligibility determination to see if they qualify for Medicaid or a subsidy.

Check premium and subsidy estimates

Two types of subsidies are available. The premium tax credit can be taken in two ways: You can apply it to monthly payments, or take it when you file your tax return. The other type of subsidy, cost-sharing, is designed to minimize enrollees’ out-of-pocket costs when they go to the doctor or have a hospital stay.df

INCOME LIMITS FOR TAX-CREDIT SUBSIDIES

Lower-income families get the most help. You may qualify for payment assistance if your employer does not offer health insurance, you do not receive Medicare, or your family does not make more than the yearly income listed in the chart to the right. Click here for more information.

Let's consider the coverage eligibility of a man we will call John Smith to see how plans coverage differ from his options for 2014 plans. The individual market in Floyd County was limited to two companies in 2014, Anthem Blue Cross and the non-profit Kentucky Health Cooperative; Humana wasn't (and still isn't) offering individual coverage there. John could chose varying levels of plans, and based on the plan type, his premiums ranged from $182 (bronze) to $421 (platinum), with deductibles ranging from $6,300 (bronze) to $500 (platinum).

In 2015, John can still only chose between Anthem and the co-op. His premium options range from $204 (KHC-bronze) to $426 (Anthem-gold), with deductibles ranging from $5,750 (Anthem-bronze) to $1,000 (KHC and Anthem-platinum). However, be careful to watch out for high out-of-pocket costs, which for most bronze and silver plans, are $6,600 per person in 2015.

The estimated monthly premiums in the chart are the full price before any payment assistance. the total premium for the plan John wanted was estimated to be $415.48, but his income qualified him for a 47 percent subsidy. Using Kynect's Health Plan Savings Calculator, John's estimated actual cost is $220.80. The Kynect website will provide estimates of premiums and assistance, but the actual amount can't be determined until you complete a full application.

Important dates to remember

There are several key dates for you to keep in mind during this enrollment period, which is shorter than the first one:

• Nov. 15: second open enrollment period began 
• Dec. 15: Consumers must select a plan for coverage to begin by Jan. 1. Currently enrolled consumers must renew coverage and application for financial system. If they fail to do so, current coverage and tax credits may be automatically renewed. (See below.)
• Feb. 15: Last say of open enrollment period. Those consumers who select a plan on this date will begin new coverage March 1. Medicaid enrollment is open year-round. 
• April 15: Deadline for filing tax returns, on which taxpayers must indicate coverage in 2014 or face a penalty. Consumers who got tax-credit subsidies in 2014 must file a tax return.

Here is a new and crucial change: If you're already enrolled in a Kynect plan in 2014 and do nothing during open enrollment before December 15, 2014, you will be automatically re-enrolled in an existing plan for next year with your existing premium tax credit.

However, consumer advocates say doing nothing could be costly. If you have experienced changes in income or other circumstances that could affect your tax credit, you risk receiving the wrong amount and may have to pay back next year. Changes in the benchmark silver plans could lead to higher costs for some consumers. Even if the premium of a particular plan may go down, the decrease in the tax credit could be even more, resulting in a net increase, so consumers should pay particular attention to these changes.

Before the tax-filing deadline on April 15, consumers must use IRS Form 8962 to reconcile their estimated premium tax credit with the final premium tax credit eligibility. Consumers who overestimated their income may receive a tax refund, but those who underestimated it may have to repay some of all of the difference.

Those who miss the enrollment deadline may still qualify for special enrollment period if they experience what the law calls "life changing events," such as moving or losing your job.

Additional changes to Kynect include an enhanced website, more call center agents, expanded call-center hours, a Kynect storefront at Fayette Mall in Lexington, and a Kynect app for Apple and Android smartphones that allows users to access their Kynect account, see details of their plan and submit photos of documents for verification.

For more information, call 1-855-459-6328 or go to www.kynect.ky.gov.

UK cancer-center director urges lawmakers to raise cigarette tax and pass a statewide smoking ban to reduce cancer deaths

The Markey Cancer Center at the University of Kentucky supports a statewide smoking ban and an increase in the state cigarette tax to significantly reduce cancer deaths in the state, the center's director told a legislative committee Sept. 3.

“We are highly supportive, and we hope that you will be supportive as well, of (these) initiatives that we think will improve the overall health of Kentuckians,” Dr. B. Mark Evers told the state legislative Tobacco Settlement Agreement Fund Oversight Committee.

A news release from the Legislative Research Commission said Evers presented the numbers to back up his advice: Kentucky is first nationally in percentage of people who get cancer, and in overall cancer mortality. Lung cancer alone accounts for about 35 percent of Kentucky cancer deaths; nationally, lung cancer's share is 28 percent.

Twenty-eight percent of adult Kentuckians smoke, with approximately 8,000 deaths each year from smoking-related illnesses. The greatest incidence of tobacco-related cancers is in Eastern Kentucky.

That is the highest percentage in the U.S., Evers notes, adding that there is an indirect relationship between cigarette taxes and smoking rates. Kentucky has the 12th lowest cigarette tax among the states.

"Raising the cost of cigarettes and a statewide smoking ban could help cut Kentucky cancer deaths by 50 percent," Evers said. That is the Markey Cancer Center's goal over the next five years.

The center has a new strategic plan, "Conquering Cancer in the Commonwealth," that focuses on the state's "major cancer killers" -- lung, head and neck, colorectal, breast, and cervical cancer.

In response to a question about how to decrease the number of smokers in Kentucky, Evers pointed to local smoke-free policies and increased efforts in Appalachia toward smoking cessation.

When asked what it will take to lower the percentage of Kentucky smokers to less than 10 percent, Evers recommended three things: increasing the cigarette excise tax, a statewide smoking ban, and instituting lung-cancer screening projects like those in place at UK and the University of Louisville.

“Those three things are really going to help drive down those numbers,” he said.