ACA Cost Sharing Reductions (CSRs) will no longer be funded

[jim584672]

Trump has decided to stop payments for the Silver plan CSRs.

Plan accordingly.

 

[Samething]

Yep. I've been planning to have 100k earmarked for insurance premiums to get me to Medicare for a while now. Pretty much saw this coming.

 

[teejayevans]

I think CSRs are for those under the 200% poverty rate, so does not effect everyone on the exchange.

 

[donheff]

I think CSRs are for those under the 200% poverty rate, so does not effect everyone on the exchange.

It affects the availability of plans on the exchanges. Insurers are leery of getting into markets where they can't get business.

 

[ShokWaveRider]

It affects me GREATLY......

 

[HillCountry]

From my reading it affects mostly above 400% FPL, they have to cover the premium increase. People on subsidy still get it.

 

[MichaelB]

This is difficult to discuss, because it appears to be an announcement but no details are available. There was an executive order on healthcare, so there are other changes to the ACA as well.

 

[Golden sunsets]

I just read an explanation of what the affect of this change would be. I had assumed that with the Gov't Subsidies gone those who qualify for the subsidies would experience varying degrees of premium increases, but the law as it currently exists actually protects the premiums of those with subsidies. The premium increases would be born only by those in the plan who don't qualify for the subsidies, as the law which has not been repealed codifies how the premiums are calculated for those below 400% of the FPL. In essence the insurance companies will no longer receive the subsidies so they will increase premiums to offset that loss. Those below 400% will experience no increased premiums and those who don't qualify will absorb the increase. Bottom line: those over 400% will go elsewhere and the insurers will pull out and the exchanges will collapse.


Sent from my iPad using Early Retirement Forum

 

[donheff]

This is difficult to discuss, because it appears to be an announcement but no details are available. There was an executive order on healthcare, so there are other changes to the ACA as well.

Here is the EO but I think it only covers the cross state association plans. I think the decision not to extend cost sharing supplements is just that - a decision, no EO required. NBC and others are saying that the WH announced the end of the cost sharing subsidies:

"Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare," the White House said in a statement.

 

[scrabbler1]

If you look closely at Form 8962 (the ACA subsidy form), you will see that there are several factors which determine one's subsidy, and some may take precedence over others. For me, and YMMV, the premium I pay has no influence on the subsidy. What does determine it are two things: (1) the 9.6% of MAGI and (2) the SLCSP, or Second Lowest Cost Silver Plan.


I wish I could get the SLCSP before I get Form 1095-A in the mail from my state's Marketplace, so I could do some tax planning before next January. I thought this figure would be well known in advance. I called my state Marketplace and asked them but they didn't know yet, maybe in late December or early January before they compile the 1095 form.


As for the CSRs, I am curious as to how the insurance companies spread out the rate increase to cover this shortfall. Is it across all Silver plans, across all plans, across all plans which qualify for a subsidy? hmmmm.....


EDIT: Golden Sunset seems to have answered my question.

 

[MichaelB]

Here is the EO but I think it only covers the cross state association plans. I think the decision not to extend cost sharing supplements is just that - a decision, no EO required. NBC and others are saying that the WH announced the end of the cost sharing subsidies:

"Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare," the White House said in a statement.

Thanks for the links.

 

[MichaelB]

An executive order was signed announcing some changes to the ACA. These cover three areas; association plans, short term plans, and employer health reimbursement arrangements. There have been subsequent media reports regarding Cost Sharing Subsidies. More announcements are likely.

In order to understand how these measures will impact us we need to know how and when they will be implemented. None of those details have been released or communicated. We look forward to detailed thread discussions on changes to the CSR, association plans, short term plans, and health reimbursement arrangements once operational details are published.

Edit to add
When this topic was first introduced no details were available, we assumed there would be additional announcements or instructions. This is not the case. So, we can proceed with forum discussion in this new thread http://www.early-retirement.org/for...ost-sharing-reductions-88819.html#post1949834