2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

APTC

With the 2020 Open Enrollment Period rapidly approaching (it actually kicks off on October 15th in California, and on November 1st in every other state + DC), it's important to keep in mind that many people who didn't qualify for financial assistance in 2019 may qualify in 2020...and in some cases that could mean a difference of thousands of dollars due to how the ACA subsidy formula works and other factors.

First, a refresher on how the ACA formula works for Individual Market enrollees (that is, people who are looking to buy health insurance for themselves and/or their family who don't receive it through their employer, Medicare, Medicaid, CHIP or some other source).

First of all, what is the Federal Poverty Level? Well, that increases a bit every year...and for 2020, it's increasing by around 2.7%:

Back in January, I noted that California Governor Gavin Newsom was proposing a stripped-down version of one of the most important ACA 2.0 provisions I've been pushing for years now: Raising the ACA's APTC subsidy income eligibility cap and beefing up the underlying subsidy formula.

At the time, he was

Well, the latest official revision to the proposed CA 2019 - 2020 state budget has been released, and not only are both the mandate reinstatement and the enhanced subsidies included, the subsidies have actually been increased a bit more than Newsom was originally proposing:

EXPANDED SUBSIDIES TO PROMOTE AFFORDABLE COVERAGE

To improve affordability and access to health care, the Governor's Budget proposed subsidies to help more low and middle class Californians afford health coverage through Covered California.

Earlier this week, a picture of a letter sent to a patient needing a heart transplant recommending that they find a way to raise $10,000 to cover some costs went viral on Twitter and Facebook, with various celebrities, politicians etc. reposting it.

I'm sure you've seen it already, but just for the record, here's one of the most viral variants, from freshman Congresswoman-elect Alexandra Ocasio-Cortz. It's important to clarify that the letter was not sent by the insurance carrier, and the $10K in question would not be going to pay an insurance company...or, in fact, even "Spectrum Health" aka the "Heart & Lung Specialized Care Clinics" noted in the letterhead.

Insurance groups are recommending GoFundMe as official policy - where customers can die if they can’t raise the goal in time - but sure, single payer healthcare is unreasonable.

PLEASE NOTE IMPORTANT UPDATES BELOW.

I just received the following from a healthcare broker, who I trust from past communication exchanges, who wishes to remain anonymous. I'm presenting it as sent, with the only changes being breaking it out into paragraphs for readability & with their state's identifying information removed.

Glossery:

Thanks to David Anderson for the heads up on this. According to Caitlin Owens of Axios...

Senate Democrats, led by Sen. Patty Murray, are pushing to increase the Affordable Care Act's subsidies as part of a stabilization bill being renegotiated with Sen. Lamar Alexander. This would mean increasing the amount of financial assistance people receive, as well as making it available to more people.

  • ...“We’re interested in both expanding access to subsidies and increasing their value. You’ve got two different sets of populations that will be impacted in different ways depending on how cost sharing” is structured, a Democratic aide told me.

Democrats also want to: