Kill the Cliff

It was just over three years ago that the American Rescue Plan Act (ARPA) dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the levels it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

It was just over three years ago that the American Rescue Plan Act (ARPA) dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the levels it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

It was just over three years ago that the American Rescue Plan Act (ARPA) dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the levels it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

It was just over three years ago that the American Rescue Plan Act (ARPA) dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the levels it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

It was just over three years ago that the American Rescue Plan Act (ARPA) dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the levels it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

It was just over three years ago that the American Rescue Plan Act (ARPA) dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the levels it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

Once again, here's what the Affordable Care Act's premium subsidy tables look like under the original ACA itself and under the American Rescue Plan (ARP). 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.

The ARP table is currently scheduled to sunset at the end of December, at which point, without legislation passing Congress & being signed into law by President Biden, it will revert back to the original ACA subsidy table:

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:

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:

President Biden, Vice-President Harris, Speaker Pelosi

As expected, the healthcare section of President Biden's first address to a joint session of Congress (technically not a State of the Union, but close enough) included a call for making the subsidies expanded under the American Rescue Plan permanent as part of the American Families Plan.

Also as expected, he did not call for other major healthcare reform priorities to be baked into the #AmFamPlan.

He did, however, spend significant time calling for those other priorities to be passed separately from the AFP...considerably more than he did on the subsidies themselves.

Before I get into the proposed healthcare policies: Early on in the speech, Biden gave a shout-out to his Administration for the success of the current, ongoing COVID Special Enrollment Period:

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