Low-Income Households and ACA Tax Policies: Benefit from Tax Credits but Paying the Penalty

We are well into the third tax year of ACA premium tax credits and the individual shared responsibility requirement. The IRS recently released a report on 2014 income tax filings that includes data on the first year of the PTC and ISRP. We analyzed this data to look at the tax credits and payments by income brackets and found that millions of low-income tax filers benefited from the PTC in 2014 – but millions of low-income tax filers also paid the ISRP, indicating that a very vulnerable population still lacks coverage. Continue reading

HHS Study Shows Benefits of Shopping and Subsidies, but Costs Still a Concern

With health insurers’ rate filings looming on the horizon, many are concerned we’ll see proposed premium increases for 2017. But a report released last week demonstrates that, behind the headlines, consumers are likely to see more affordable premiums after they’ve shopped for the best deal. At the same time, another study shows that consumers’ out-of-pocket costs for health services are steadily rising. Sean Miskell has the details. Continue reading

Getting MAGI Right: Current Monthly Income Vs. Projected Annual Income

Under the Affordable Care Act, new rules for counting household size and income for purposes of Medicaid and CHIP eligibility were aligned with the calculation of Marketplace subsidies. Following up on a primer she drafted on the basics of MAGI, our colleague at Georgetown’s Center for Children and Families, Tricia Brooks, drills down on income eligibility for Medicaid, CHIP, and premium tax credits. Continue reading

New “Halbig Provision” in Health Plan Agreements Poses Little Threat to Consumers

Insurers that sell coverage through the ACA’s federally facilitated marketplaces must sign a privacy and security agreement with the federal government. New language gives insurers greater flexibility to end that agreement if premium tax credits cease to be available to marketplace enrollees. Justin Giovannelli explores the significance of this development for consumers. Continue reading

Do Nothing to Renew or Get an Updated Eligibility Determination? CMS Puts out Final Marketplace Renewal Rules

Last week the federal Centers for Medicare and Medicaid Services (CMS) published final rules for the health insurance marketplaces and participating insurers to renew consumers into coverage for 2015. Our colleague from Georgetown’s Center for Children and Families, Tricia Brooks, discusses what the rule means for consumers and their families. Continue reading

After Halbig: Considerations for States Revisiting the Option to Establish a State-Based Marketplace

A federal appeals court’s ruling that premium subsidies aren’t available for consumers who purchase health coverage through one of the ACA’s federally run insurance marketplaces could have drastic consequences. But policymakers in the 34 states with a federal marketplace have options for protecting their residents. In one of CHIR’s blogs for the Commonwealth Fund, Kevin Lucia and Justin Giovannelli discuss those options here. Continue reading