October 31, 2017
Open enrollment begins tomorrow
Open enrollment faces serious challenges this year including higher premiums, a shorter sign-up period with less assistance, fewer advertisements and confusion around the status of the ACA. Some consumers also have fewer options, as the number of insurers participating dropped from 167 in 2017 to 132 in 2018. For the first time, the Administration has not forecasted an enrollment number for 2018. Experts are predicting as many as 1 million fewer people may sign up this year.
Tech United for Independent Access – a new coalition that’s led by Fiverr, Care.com, DoorDash, Etsy, Postmates and others – says it will step in to do ACA-related outreach of its own, hosting community events and sending alerts via apps and social media to boost awareness. The companies touch more than 3.5 million people. A survey of freelancers who use Fiverr found that almost 25 percent turned to a health insurance marketplace to obtain coverage.
Subsidies may offset premium hikes, some may get plans for $0
New data indicates the average cost of popular, middle-priced plans will be about 27 percent higher in 2018, however subsidies could help consumers who shop around. While the average premium is higher, the average subsidy is also increasing. The average tax credit in 2018 will rise to $555 — up 45 percent from 2017’s average credit of $382. That means many people can take that larger tax credit and buy comparable or better insurance for less money.
In some counties, certain consumers may be able to enroll in a basic bronze plan for a zero-dollar monthly premium as a result of higher federal spending for premium subsidies. Because consumers can use subsidies to purchase any type of coverage, that money could cover the full price of a lower-cost plan.
Repealing the ACA’s individual mandate
Senator Tom Cotton (R-AK) has proposed repealing the ACA’s individual mandate through tax reform legislation, which is set to be unveiled tomorrow. The move raises concerns that including health care provisions in a tax reform package could make it harder for lawmakers to pass tax legislation. A December 2016 estimate by the nonpartisan Congressional Budget Office found that ending the mandate’s tax penalty could raise $416 billion over a decade, while causing 15 million people to lose coverage.
Bipartisan support exists for funding of community health centers
In a letter to Speaker Paul Ryan (R-WI), a bipartisan group of more than 150 lawmakers is calling for Congress to reauthorize funding for community health centers, which care for some of the nation’s most vulnerable patients. The funding, which makes up 70 percent of federal grants to the health centers, was reauthorized in 2015 and expired at the end of September. Community health centers serve more than 25 million people regardless of their ability to pay for their medical services.
Trump administration and House seek to continue pause on legal battle of CSR subsidies
The House of Representatives and the Trump Administration are looking to wind down the House’s 2014 lawsuit challenging the legality of CSR payments. On Monday, the Administration and the House said they wanted the case to remain on hold, as it has been since December 2016, as they decide how to unwind the suit. However, ending the case could be complicated in light of the involvement of states.
Medicaid growth flat for first time under ACA
There was no significant growth in the number of Medicaid beneficiaries this year, according to a recent report. Roughly 75 million Americans are enrolled in Medicaid, but that reflects an increase of just 98,000 beneficiaries over last year. The chief reason for flat enrollment: It was the first year since 2013 that no states moved forward with expansion. The share of Medicaid beneficiaries in private plans continues to edge upward. This year, 73 percent of all enrollees are in managed care plans, a 1.5 percent increase over last year. Since 2013, insurers have added 20.8 million customers to their roles, outstripping total growth in the Medicaid program.
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