Post-Tribune, Merrillville, Ind., Trudy Lieberman column
The failure of
In mid-October,
To understand this, let's take a step back. Legislators who wrote the law knew that a big reason people did not buy health insurance was cost. Most middle class families without employer coverage struggled to pay the premiums in the so-called individual market where they had to shop. Those at the bottom of the income ladder either qualified for Medicaid or did without insurance. About 44 million Americans did not have insurance when the law took effect four years ago.
The ACA tried to make it easier to buy coverage, and
One comes in the form of tax credits the government advances to shoppers who buy Obamacare-compliant policies that meet certain rules and regulations, such as offering 10 essential benefits. Prescription drug coverage is one. Those subsidies are based on a family's income and phase out when a family's income exceeds 400 percent of the federal poverty level or about
The other subsidy is called a cost-sharing subsidy, sometimes referred to as a CSR and aimed at Americans whose incomes are at or below 250 percent of poverty, about
The latter are the subsidies on the chopping block. The president said the government will not continue funding them which means the government simply will not pay insurance companies for reducing the out-of-pocket costs to policyholders. Policyholders will still get the subsidies unless
If you get those subsidies, you're not off the hook, though. Insurance companies anticipated that the president would cut the subsidies and they increased their premiums for most or all Obamacare policies, including the silver plans, the ones people must buy to receive the extra help with cost sharing.
The
So who will be hurt the most by the Trump administration's latest move which some experts argue undermines the stability of the health law?
Insurance companies have already prepared for this and have cushioned the blow to them by charging higher premiums to everyone who buys in the individual market. People with incomes under 400 percent of poverty will still receive their tax credits, which will reduce their higher premiums, and they will continue to get their CSRs.
Those in the individual market who have higher incomes and receive no tax credits to lower their premiums will feel the most pain.
"Ironically, it is these unsubsidized folks who have complained the loudest about Obamacare's big premiums and deductibles," says
The administration wants to let them buy cheaper policies that cover far less than Obamacare insurance.
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