AmRescuePlan

The Centers for Medicare & Medicaid Services (CMS) has just sent out guidance about how the newly-expanded & enhanced subsidies will work for those currently enrolled in (or newly enrolling in) healthcare policies via the federal ACA exchange, HealthCare.Gov.

It's important to note that the following guidelines only apply to residents of the 36 states hosted via HC.gov. The timing, policy and procedures for the new/expanded subsidies for residents of the 15 states which operate their own ACA exchanges may vary.

With that in mind, here's how CMS says things will work via HealthCare.Gov.

The first section is mostly just an overview of the ARP and a refresher on how ACA subsidies are calculated...

American Rescue Plan and the Marketplace

The New Law

Yesterday I wrote a long, wonky post about an unusual case involving a legally-present (green card), unemployed Nigerian immigrant.

The short version is that because his income is so low, he normally wouldn't be eligible for ACA subsidies...except because he lives in Maryland, a Medicaid expansion state, he would normally be eligible for Medicaid...except that because he's an immigrant who's been in the United States for less than five years, he isn't eligible for Medicaid...except that, thanks to an obscure provision baked into the Affordable Care Act, he is eligible for ACA subsidies after all!

‘(B) SPECIAL RULE FOR CERTAIN INDIVIDUALS LAWFULLY PRESENT IN THE UNITED STATES.—If—

‘‘(i) a taxpayer has a household income which is not greater than 100 percent of an amount equal to the poverty line for a family of the size involved, and

My biggest takeaway from the press releases below is that everyone will be made whole (that is, those eligible for additional subsidies or newly-eligible for subsidies at all will receive them in full), but that it may take anywhere from a few weeks to several months for that to happen, so cool your jets.

Covered California:

Covered California Hails the Signing of the American Rescue Plan Which Will Benefit Millions

SACRAMENTO, Calif. — Covered California’s executive director, Peter V. Lee, issued this statement following President Joe Biden’s signing of the American Rescue Plan. The landmark legislation provides new financial help to people who receive their health insurance through Affordable Care Act marketplaces like Covered California. The measure will lower health care costs by providing new and expanded subsidies to more Americans than ever before.

UPDATE: Everything below refers to HR 369, but the American Rescue Plan, HR 1319, contains a virtually identical expansion of ACA subsidies...if only for two years.

Note that under HR 1319 (AmRescuePlan), the first year would be retroactive, meaning that current ACA enrollees should receive additional subsidies dating back to January 2021, though I don't know what form that will take...rebate checks, credit towards future premiums or an extra tax refund next spring.

Over the past couple of years, one of the things I've become known for is my obsessive fixation on visually displaying how much various households would save on healthcare premiums if various ACA subsidy-boosting bills were passed compared with the current ACA subsidy structure.

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