For three years running, thanks to a combination of the way the ACA's premiums subsidy formula works and the Silver Loading workaround, several million low-income people are eligible for fully ACA-compliant healthcare policies which end up costing them NOTHING in premiums after federal tax credits are applied.
Here's why: Under the ACA's subsidy formula, if you earn between 100% - 400% of the Federal Poverty Line ($12,490 - $49,960/yr if you're single), you're eligible for subsidies which bring the cost of the benchmark Silver ACA plan down to between 2.06 - 9.78% of your income, on a sliding scale.
If you earn less than 200% FPL (just under $25,000), you also qualify for heavy cost sharing reduction assistance as well...but only if you enroll in a Silver plan.
So, let's suppose you earn exactly $25,000/yr (just over 200% FPL). At that income, you'd qualify for subsidies bringing the benchmark Silver down to 6.5% of your income, or $135/month. If the benchmark plan costs, $600 at full price, you'd therefore be eligible for $465/month.
The clock is ticking on picking the best health insurance plan for 2020. High quality and affordable health coverage is available through HealthSource RI, and Rhode Islanders have until December 23rd to purchase coverage that starts on January 1st.
Getting health insurance is even more important this year because coverage is now required in the state of Rhode Island. As of January 1st, residents who don’t have health insurance will pay a tax penalty when filing for the prior year.
AGAIN: The federal shared responsibility requirement (aka the individual mandate penalty) may have been zeroed out by Congressional Republicans, but in addition to the District of Columbia, four states (Massachusetts, New Jersey, California and Rhode Island) have reinstated it at the state level.
I'm just putting this out there today because I know there's gonna be a bunch of eye-rolling stories completely misunderstanding the data later on this week.
Last Wednesday, the Week 4 HealthCare.Gov Snapshot Enrollment Report came out and showed a "mysterious" 41% increase in ACA exchange enrollments for the week vs. last year...jumping from 500,437 QHP selections to 703,556 QHP selections for the corresponding week this year.
This Wednesday, the Week 5 snapshot report will come out and will almost certainly show a "mysterious" large drop in ACA exchange enrollments vs. last year...from 772,250 down to perhaps 500,000 or so.
This isn't the biggest development in the world, but exactly a year ago today I made a big fuss about how New Jersey (and DC) had reinstated their own health insurance individual mandate penalties after the federal version was zeroed out by Congressional Republicans...but didn't seem to be going through much effort to let people know about the penalty.
While Massachusetts had launched a massive multi-media awareness/education blitz statewide to make sure people knew that they had dusted off their pre-ACA coverage mandate requirement, New Jersey and DC didn't appear to be doing much, if anything, to let people know that they'd face a stiff tax penalty if they didn't either #GetCovered or qualify for an exemption.
As I noted at the time, just like the Doomsday Device in Dr. Strangelove, it completely defeats the whole point of having a penalty if no one knows it exists.
I'm just putting this out there today because I know there's gonna be a bunch of eye-rolling stories completely misunderstanding the data later on this week.
Last Wednesday, the Week 4 HealthCare.Gov Snapshot Enrollment Report came out and showed a "mysterious" 41% increase in ACA exchange enrollments for the week vs. last year...jumping from 500,437 QHP selections to 703,556 QHP selections for the corresponding week this year.
This Wednesday, the Week 5 snapshot report will come out and will almost certainly show a "mysterious" large drop in ACA exchange enrollments vs. last year...from 772,250 down to perhaps 500,000 or so.
Around 7,000 or so of this drop will likely be due to Nevada splitting off onto their own ACA exchange. A small number will be due to Idaho expanding Medicaid. But the vast bulk of this seemingly disastrous ~35% drop will be for a far simpler reason...the same one which caused the seeming 41% spike last week: Thanksgiving.
This was posted by NJ Governor Phil Murphy a week ago but it's still noteworthy, especially considering that NJ is in the process of splitting off from HC.gov onto their own full ACA exchange next year as Nevada just did:
Governor Murphy and New Jersey Department of Banking and Insurance Kick Off ACA Open Enrollment Period
Governor Announces Strengthened ACA Efforts, including $3.1 Million to Support Outreach and Enrollment Efforts and Bolstered Get Covered NJ Awareness Campaign
TRENTON – Governor Phil Murphy, joined by Department of Banking and Insurance (DOBI) Commissioner Marlene Caride and enrollment assisters from across the state, today announced Navigator grant awards totaling $1.1 million to provide enrollment assistance to residents shopping for health coverage during the six-week open enrollment window. DOBI plans to release approximately $500,000 more in grants in the coming days.
Need health insurance in 2020? Now’s the time to pick or renew your plan
HealthSource RI announces 2020 Open Enrollment period Nov. 1st – Dec 31st
EAST PROVIDENCE, RI (October 31, 2019) HealthSource RI, the state health insurance exchange, helps connect Rhode Islanders to a wide range of high quality, affordable health coverage options. Residents are encouraged to select and pay for a plan through HealthSource RI by December 23rd for coverage beginning January 1, 2020. The last possible day to enroll and pay for a plan is December 31st, but customers may experience a delay in receiving ID cards if they enroll after December 23rd.
“HealthSource RI helps keep health care costs low while ensuring that Rhode Islanders have access to high-quality care,” said Governor Raimondo. “I urge Rhode Islanders to take time to explore HealthSource RI’s many coverage options this open enrollment.”
Starting today, November 1st, the Seventh Annual ACA Open Enrollment Period is upon us! As I do every year, here's a list of important things to remember when selecting a health insurance policy. Some of these are the same every year and apply nationwide; others are specific to the 2020 enrollment period and/or to particular states.
1. DON'T MISS THE DEADLINE!
California actually launched Open Enrollment for 2020 on October 15th, but for the other 49 states (+DC) it starts on November 1st. The deadline for Open Enrollment is December 15th in most states for coverage starting January 1st, 2020, but eight states which operate their own ACA exchanges have extended deadlines:
DC Health Link Pulling Out All the Stops for African-American “Week of Action”
Friday, January 18, 2019
Marching in MLK, Jr. Day Parade, barber shop outreach, and visiting churches highlight opportunities to boost African-American health insurance enrollment
WHAT/WHO:
With less than two weeks left to the January 31 deadline to sign up for 2019 coverage, DC Health Link is ramping up outreach efforts to the African-American community, where the uninsured rate remains high. DC Health Link, in partnership with various community organizations, is encouraging uninsured African-Americans to enroll in quality, affordable health insurance during DC Health Link’s “African-American Week of Action.”
Given how much I've been shouting from the rooftops about the importance of everyone #GettingCovered the past month or so, I'm fully aware of the irony of what I'm about to say:
My wife and I finally #GotCovered this morning at HealthCare.Gov.
We logged into our current account, reviewed our options and in the end settled on...pretty much the same Gold HMO we already have today. It's actually a slightly different policy--Blue Care Network of MIchigan elimiated the "HMO Select" option and replaced it with the "HMO Preferred" option. As far as we can tell, the only differences are the (unsubsidized) premium price, which shot up by about $300/month (ouch.) and the deductible, when went up from $500 to $1,000.
For us, we had two major decisions to make: Gold vs. Silver...and (assuming we had gone with Silver), On-Exchange vs. Off-Exchange.
