“These savings will decrease premiums for many, on average, by $50 per person per month and $85 per policy per month. On average, one out of four enrollees on HeathCare.gov will be able to upgrade to a higher plan category that offers better out of pocket costs at the same or lower premium compared to what they’re paying today,” HHS added. Which is a good reminder for people who have insurance through the ACA marketplace that it’s worth doing some comparison shopping while enrollments—and reenrollments—are open.
More than 200,000 people signed up for ACA coverage during the first two weeks of the special enrollment period President Biden initiated in February, in what was initially going to be a 90-day window. The response—and the need by people who’d lost insurance because of the pandemic—has been so great that it warranted the extension.
Starting April 1, the new subsidies under the Rescue Plan will be available to enrollees. Kaiser Family Foundation estimates that about 8 million people who will now be able to get help paying their premiums through the ACA. That includes “about 3.3 million people buying off-exchange coverage and 1.4 million people buying unsubsidized on-exchange plans, presumably because many were ineligible to buy subsidized coverage.” Here’s an example from KFF of the savings individuals could realize:
Compared to current premium payments, a 60-year-old with a $55,000 income would pay 77% less for a bronze plan ($146 vs. $634 per month), 56% less for a benchmark silver plan ($390 vs. $887 per month), and 52% less for a gold plan ($453 vs. $951 per month), on average, under the COVID-19 Relief law. Many young adults with incomes above 400% of poverty who are currently in the subsidy cliff would also see savings under the COVID-19 relief law, but those savings would be more modest (a 6-9% drop, depending on the metal level, for an average 27 year old).
In addition, the increased subsidies included in the Rescue Plan mean many people who already qualified for assistance will see substantial drops in premiums, particularly low-income enrollees who are guaranteed zero-premium silver-level plans. KFF estimates that at least 3.4 million “of the lowest income enrollees would see a 100% decrease in their premium contribution.” The Centers for Medicare & Medicaid Services (CMS) say that “Four out of five enrollees will be able find a plan for $10 or less/month after premium tax credits, and over 50% will be able to find a Silver plan for $10 or less.”
It looks like the incentives the bill included to get the states that have so far refused to take Medicaid expansion (Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming) might be working as well, at least for Wyoming and Alabama. Already, the federal government pays a permanent matching rate of 90% for the expansion population in the states that expanded Medicaid under the ACA, and under the new law, it is offering an additional 5% matching rate to those 12 states which haven’t accepted it yet for a two-year period, no matter when they expand. That’s on top of a temporary 6.2% matching increase that is in effect for the duration of the pandemic emergency.
The Wyoming state House passed Medicaid expansion on Wednesday, the first time Medicaid expansion has passed in the state since the ACA made the option available. It still has to get through the Senate, but it’s a crack in the monolith of opposition in this very red state. Alabama Gov. Kay Ivey is now “open to the discussion” of expanding, also a newly opened crack in the opposition. That would extend healthcare coverage to about 300,000 uninsured people.
“With the American Rescue Plan and Affordable Care Act, millions of families may be able to sleep more soundly at night and they don’t have to worry about losing everything they have saved,” Biden said Tuesday, in remarks commemorating the ACA anniversary. It’s hard to argue against that summation, as much work as there is still to be done.