American Rescue Plan

A month ago I posted an analysis which gave a general idea of how much more various households will have to pay in health insurance premiums if the expanded financial subsidies provided by the American Rescue Plan (ARP) are allowed to expire at the end of this year.

Again, here's what the subsidy tables look like under the ACA itself and under the American Rescue Plan. The premium caps are the maximum percent of household income which a household has to pay for the benchmark Silver plan at various income ranges:

A few weeks ago I sounded the alarm about the massive health insurance premium rate hikes which millions of ACA enrollees will face starting in January 2023 if the American Rescue Plan's (ARP) enhanced premium tax credits aren't extended beyond their current expiration date at the end of 2022.

Today, the Urban Institute, supported by the Robert Wood Johnson Foundation, released a detailed analysis which projects just how many people would likely find themselves priced out of the health insurance market, thus losing healthcare coverage, if the ARP subsidies aren't extended. They delve into the impact at different income brackets and even break out their estimates by state:

Key Findings

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via the Centers for Medicare & Medicaid Services:

The Biden-Harris Administration is announcing that, beginning today, as many as 720,000 pregnant and postpartum people across the United States could be guaranteed Medicaid and Children’s Health Insurance Program (CHIP) coverage for a full 12 months after pregnancy thanks to the American Rescue Plan (ARP). Medicaid covers 42 percent of all births in the nation, and this new option for states to extend Medicaid and CHIP coverage marks the Biden-Harris Administration’s latest effort to address the nation’s crisis in pregnancy-related deaths and maternal morbidity by opening the door to postpartum care for hundreds of thousands of people.

New Mexico

Back in 2020, New Mexico attempted (but ultimately failed) to pass a bill establishing a new "Healthcare Affordability Fund" which would be used primarily to reduce individual market (ACA) health insurance premiums:

New Mexico would raise a state health-insurance tax and dedicate the new revenue to programs intended to make health care more affordable under a proposal that passed the state House on Sunday.

Rep. Deborah Armstrong, D-Albuquerque, described the legislation as an unusual opportunity to generate more revenue for health care without increasing the total amount consumers now pay.

The increased state tax would partially replace a federal tax that’s being repealed, she said, meaning health insurance carriers would actually be charged less in taxes than they are now, even after the state increase.

The legislation, House Bill 278, would raise about $125 million in annual revenue when fully phased in — the bulk of it dedicated to a new fund for health care affordability, according to legislative analysts.

American Rescue Plan Subsidies

For years now, I've been a tireless advocate for dramatically expanding & improving the Affordable Care Act's Advance Premium Tax Credit (APTC) formula. This is the table which determines a) just how generous the ACA's health insurance premium tax credits are at different income levels and b) how far up the income ladder those financial subsidies extend.

Just over a year ago, the American Rescue Plan (ARP), passed by Democrats in Congress and signed into law by President Biden, did exactly what I've been clamouring for all this time: It made ACA subsidies far more generous while also removing the completely arbitrary income eligibility cut-off threshold (otherwise known as the "Subsidy Cliff."

As a refresher, the way the ACA subsidies work is as follows:

Covered California Logo

I'll be posting my own urgent analysis/warning about this separately soon as well, but Covered California has beaten me to the punch:

  • A new Covered California analysis describes the potential impact to consumers if the increased health insurance subsidies that were part of the American Rescue Plan are allowed to expire at the end of 2022.
  • In California, all consumers would face premium increases, including 1 million lower-income consumers (individuals earning less than $32,200 per year), who would see their premiums more than double.
  • In addition, middle-income individuals and families (for individuals, those earning more than $51,520 per year), would no longer be eligible for any financial help and would face higher monthly premium costs that for many will mean annual cost increases in the thousands of dollars.
  • The increase in costs could force more than 150,000 people in California and more than 1.7 million nationally to drop their health insurance.

La versión en español de este Comunicado puede ser descargada en este enlace

ASPE Logo

In the midst of all the data & stats from this morning's CMS report touting the most successful ACA Open Enrollment Period ever, I almost forgot another important related report which the Biden Administration is promoting as well:

This week, HHS’s office of the Assistant Secretary for Planning and Evaluation (ASPE) is also releasing a report analyzing new survey data that showed the uninsured rate fell in 2021 after the American Rescue Plan and outreach efforts took effect. According to the report, the uninsured rate for U.S. population was 8.9% for the third quarter of 2021 (July – September 2021), down from 10.3% for the last quarter of 2020 – corresponding to roughly 4.6 million more people with coverage over that time period. Coverage gains occurred among both children and working age adults, with the largest coverage gains for those with incomes under 200% of the poverty level (roughly $27,000 for a single adult or $56,000 for a family of four).

Washington HealthPlan Finder

A couple of years ago, Washington became the first state to implement their own "Public Option" ACA healthcare plan...sort of. The actual version of the PO which was implemented ended up being considerably less impressive than the original vision, but hey, it was a start.

However, the same legislation which created the "Cascade Care" program also included another provision which was noteworthy at the time:

Washington HealthPlan Finder

This just in from the Washington Health Benefit Exchange...

Record Numbers of Washingtonians Sign Up for Health Care Coverage During 2021 Special Enrollment Period

  • LATEST DATA SHOWS IMPACT OF AMERICAN RESCUE PLAN ACT SAVINGS. NEARLY HALF OF ALL CUSTOMERS PAY LESS THAN $100 PER MONTH.

Washington Health Benefit Exchange (Exchange) announced on Tuesday more than 57,000 Washingtonians signed up for health care coverage between February 15 and August 15 on the state’s insurance marketplace, Washington Healthplanfinder. The Exchange opened a Special Enrollment Period in February in response to the COVID-19 Public Health Emergency. This allowed any individual in Washington the opportunity to apply for coverage or compare and upgrade their existing insurance.

CMS Logo

 

Thanks to Amy Lotven of Inside Health Politics for the heads up:

CMS Thursday (July 15) announced a new advertising campaign that will run in the final 30 days of the special enrollment period slated to end Aug. 15, and the agency also confirmed Inside Health Policy’sreport that the agency plans to auto-adjust tax credits for consumers who do not return to the federal marketplace starting Sept. 1.

Sure enough, this press release was put out by CMS earlier today:

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