New Healthcare Bill - ACA Subsidy extended for 3 Years .. anyone has more details?

[cyber888]

As someone retiring next year, this is good news for me.
Looks like the new bill extends ACA enhanced subsides for 3 more years. I assume from Jan. 2023 to Jan. 2026 ?
Looks like this will again remove the "ACA Cliff problem".
And maybe will raise premiums slowly in the next 3 years.
Anyone has anymore legal details on this bill would be appreciated.
(This post is never meant to be political, just wanted to get more details on the future ACA landscape if you have any more info on the new bill. Thanks)

https://www.fiercehealthcare.com/pay...g-price-reform

[erkevin]

https://www.kff.org/policy-watch/fiv...act-subsidies/

This might add a little information.

[ownyourfuture]

Quote:

Originally Posted by erkevin https://www.kff.org/policy-watch/fiv...act-subsidies/ This might add a little information.

Thanks for the link. The title says it all.
Five Things to Know about the Possible Renewal of Extra Affordable Care Act Subsidies.

Looks like we'll just have to wait & see.

[jim584672]

Looks like a done deal. The changes to Medicare are a big deal. $2,000 max OOP for Part D drug costs. Currently you need to OOP $7,050 before you get drugs at 5% of cost. $35 a month for insulin for Medicare beneficiaries made it in, just not for everybody.

[orchid55]

I asked this question on another thread about a different part of the bill. If the max OOP for Part D drug costs is $2,000 will the Part D companies just eat the extra costs or pass it along to us in the form of much higher premiums?

[aaronc879]

Quote:

Originally Posted by orchid55 I asked this question on another thread about a different part of the bill. If the max OOP for Part D drug costs is $2,000 will the Part D companies just eat the extra costs or pass it along to us in the form of much higher premiums?

I would assume the Government covers the extra bills beyond $2000/yr per person. Isn't that what the money is for that is in the bill? The insurance company shouldn't have to raise prices on non-Medicare people.

[SecondCor521]

Quote:

Originally Posted by cyber888 As someone retiring next year, this is good news for me. Looks like the new bill extends ACA enhanced subsides for 3 more years. I assume from Jan. 2023 to Jan. 2026 ? Looks like this will again remove the "ACA Cliff problem". And maybe will raise premiums slowly in the next 3 years. Anyone has anymore legal details on this bill would be appreciated. (This post is never meant to be political, just wanted to get more details on the future ACA landscape if you have any more info on the new bill. Thanks) https://www.fiercehealthcare.com/pay...g-price-reform

Yes, the new bill if passed would both (a) extend the more generous ACA subsidies originally enacted in March last year as part of the ARP Act, and (b) continued suspension of the 400% FPL cliff in the ARP Act.

Both provisions would now expire 1/1/2026, which I guess would make that a busy day for the IRS as that is also when the TCJA tax cuts expire I believe.

The bill has passed the Senate, and now requires a vote in the House and the President's signature. These seem like formalities to me.

The actual text of the bill can be found here:

https://www.congress.gov/congression...rticle/S3922-5

The section dealing with ACA subsidies is 12001; you can search on that text in the above link to read it yourself.

[travelover]

Looks like the cap on insulin cost was stripped out.

[Calico]

Quote:

Originally Posted by travelover Looks like the cap on insulin cost was stripped out.

The cap remains for those on Medicare, but it was stripped out for those on private insurance.

[bobandsherry]

Quote:

Originally Posted by ownyourfuture Thanks for the link. The title says it all. Five Things to Know about the Possible Renewal of Extra Affordable Care Act Subsidies. Looks like we'll just have to wait & see.

That article was from July 22, before passage now.

[ownyourfuture]

Quote:

Originally Posted by SecondCor521 The actual text of the bill can be found here: https://www.congress.gov/congression...rticle/S3922-5 The section dealing with ACA subsidies is 12001; you can search on that text in the above link to read it yourself.

Thank You.

[MBSC]

Quote:

Originally Posted by jim584672 Looks like a done deal. The changes to Medicare are a big deal. $2,000 max OOP for Part D drug costs. Currently you need to OOP $7,050 before you get drugs at 5% of cost. $35 a month for insulin for Medicare beneficiaries made it in, just not for everybody.

2023 Part D plans have already been submitted for regulatory approval so the initial changes are minimal.

2023: Eliminates cost sharing on Part D adult vaccines like those used to prevent Shingles.
2024: Eliminates the 5% Part D catastrophic cost share.
2025: Adds $2,000 MOOP to Part D with annual inflation adjustment thereafter.
2026: CMS can negotiate prices for up to 10 expensive Part D drugs.
2027: CMS can negotiate prices for up to 15 expensive Part D drugs.
2028: CMS can negotiate prices for up to 15 expensive Part B & D drugs.
2029+: CMS can negotiate prices for up to 20 expensive Part B & D drugs.

Quote:

Originally Posted by orchid55 If the max OOP for Part D drug costs is $2,000 will the Part D companies just eat the extra costs or pass it along to us in the form of much higher premiums?

"Because enrollee premiums finance 25.5 percent of the Part D program, we estimate that the $2,000 OOP spending cap would have required an additional $199 million in beneficiary premium spending and an additional $583 million in Medicare program spending in 2019. For context, the change to beneficiary premiums is equal to raising the premium for the standard benefit across the 45.8 million Part D beneficiaries in 2019 by $4.35 ANNUALLY, and the change in Medicare program spending represents less than 1 percent of the $97.6 billion in total Part D expenditures that year."

Source: https://www.urban.org/sites/default/...ng-at-2000.pdf

[harllee]

The Medicare changes will be a huge benefit for DH. He takes a very expensive drug (Humira) and goes through the Part D donut hole in the first month of the year. His out of pocket for Humira has been running over $8000 per year.

[cyber888]

Thanks for the link. Opened it using Acrobat and indeed saw it expiring at 1/1/2026 and it says subsidies will make ACA more afford till then. Good for retirees next year like myself.

Quote:

Originally Posted by SecondCor521 Yes, the new bill if passed would both (a) extend the more generous ACA subsidies originally enacted in March last year as part of the ARP Act, and (b) continued suspension of the 400% FPL cliff in the ARP Act. Both provisions would now expire 1/1/2026, which I guess would make that a busy day for the IRS as that is also when the TCJA tax cuts expire I believe. The bill has passed the Senate, and now requires a vote in the House and the President's signature. These seem like formalities to me. The actual text of the bill can be found here: https://www.congress.gov/congression...rticle/S3922-5 The section dealing with ACA subsidies is 12001; you can search on that text in the above link to read it yourself.