…certain income losses or exclusions. Therefore, some tax filers receiving PTCs appear to have incomes below the minimum income levels for PTC. In addition, the report does not provide data on household size or any demographic data related to the PTC or ISRP. (If you want a thorough breakdown of the tax provisions of the ACA before you wade into…
…2014 premium rates. Yet another budget deal in 2014 required the ACA’s risk corridor program to be budget neutral, limiting the amount the federal government could remit to insurers for their losses. As a result, marketplace insurers received only 12 cents on the dollar for 2014. This was a particularly harsh blow for the CO-OPs, which lacked the financial cushion…
…another special enrollment. In this particular situation, loss of marketplace coverage because you failed to submit verifying documents does not trigger a special enrollment due to loss of qualifying coverage or loss of minimum essential coverage. If you do have another life event like you move or get married, then you could apply based on those events for a special…
…the loss of a job, a move, or marriage, to buy a plan outside of the annual enrollment period. So short-term coverage is no longer one of the only ways for people to get transitional coverage. The Administration finds that, post-ACA, insurers have stretched the short-term policy definition beyond recognition. Many people are not only purchasing short-term plans as their…
By Henry J. Aaron*, Kevin Lucia and Justin Giovannelli Health reform (aka Obamacare) is entering a new stage. The recent announcement by United Health Care that it will stop selling insurance to individuals and families through most health insurance exchanges marks the transition. In the next stage, federal and state policy makers must decide how to use broad regulatory powers…
…back to the United States from abroad; and moving to a state that expanded Medicaid and having a change in income making that consumer eligible for financial assistance. The rule also eliminates the requirement that people be allowed to use the moving SEP 60 days in advance of a move and eliminates the SEP for the loss of a dependent…
…we are pleased to see that the final rule better incorporates pediatric providers. For example, the final rule requires states to develop pediatric network adequacy standards for the following classes of providers: primary care, behavioral health (including mental health and substance use disorder), specialists, and dental. Accountability and Transparency: The final rule maintains the minimum medical loss ratio of 85%…
…the different SEPs that are available (for example, due to a permanent move rather than loss of other coverage). However, that data is not available in the report, nor is there data to show reasons enrollees allow coverage to lapse (for example, because an enrollee obtained other coverage). My fellow consumer representative, Sarah Lueck, offered a consumer perspective on SEPs,…
…sell ACA-compliant plans through 23 marketplaces, citing financial losses. What is short-term health insurance and why do insurers like selling these policies? We’ve written about short-term health insurance on CHIRblog before, noting that these policies are not regulated by the ACA, and thus don’t need to comply with federal prohibitions on pre-existing condition discrimination, out-of-pocket cost protections, or requirements to…
…cost increases in check. In her testimony, Ms. Corlette emphasized: In spite of early fears that the Affordable Care Act (ACA) would result in job losses and a decline in employer sponsored insurance (ESI), the opposite is in fact true. The foundation of ESI as a source of health coverage in this country remains as strong as ever, and employers…
The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.
