So here is the third subsidy bonus for large families. Not only are you billed for only three children, but you get a larger subsidy based on the entire household size. When you combine that with the inflated Silver plan rates, relative to the lower off-exchange Silver plans, large families get a nice subsidy to lower their health insurance premiums. You don’t pay for any more than three children, but you get the Premium Tax Credit as if the whole family were being billed for health insurance.
The proposed rule is complicated and has many conditions and exclusions. Because of this complexity, many individuals and families with lawful permanent status, and enrolled in Covered California, or who have children enrolled in Medi-Cal, are fearful as being labeled as a Public Charge. Covered California has sought to allay the fears of people who might be affected by the proposed rule that their participation in Covered California and monthly premium tax credit subsidy they receive will not adversely impact their status.
Covered California consumers are penalized for having the good fortune of their household income’s increase. To add another layer of insult, if the consumer makes over 400% of the federal poverty level, they have to repay all the monthly tax credit subsidies they received during the year and pay for an artificially inflated Silver plan rate. Ouch!
The Covered California agent service representative said I was about the fifth agent he worked with to identify the missing dependent tax status question. He could see the question in his system, but I couldn’t see the question on my client application. When he indicated that Debbie was to be claimed as a dependent of Susan, the APTC monthly subsidy was awarded.
If a consumer was in a market where the only choices were Blue Cross and Blue Shield, and Blue Cross was the SLCSP (Blue Shield necessarily being the least expensive Silver plan offered) then these consumers may see their relative tax credit subsidy decrease. This will hold true if the Blue Shield plan, and now the only plan available, continues to have a rate lower than what Blue Cross would have had in 2018.
In order determine how my clients might be affected by the proposed new Premium Tax Credits under the American Heath Care Act (AHCA or Trumpcare) introduced by the Republicans in March 2017, I compared the current income based Premium Tax Credits under the ACA to the new age based tax credits of the AHCA. On average, my clients included in the comparison will lose $157 per month to help pay for their health insurance. Young individuals, under 30 years old, have the smallest change of premium tax credit under the age based rules. Within my clients, people over 55 year old will get hit the hardest losing $200 to $400 per month in premium tax credit assistance.
Covered California has given their online health insurance enrollment system a serious make over with the release of the CalHEERS 17.2 build. Not only has the user interface been enhanced, members must now enter their employer’s contact information before they will be eligible for the monthly subsidy. In addition, Covered California will begin notifying a member’s employer when they enroll or renew their Covered California health insurance.
After Covered California acknowledged at the January 2017 Board meeting that they had system issues that affected over 40,000 consumers, new enrollment problems seem to be boiling up. Some consumers have reported that household members who are ineligible for Covered California family dental plans have been automatically enrolled in dental insurance in 2017. In some very rare instances, the Covered California system is allowing consumers to actively enroll in two different subsidized health plans.
Some Covered California consumers are receiving confusing letters stating they are either not eligible for health insurance or will be awarded no monthly tax credits for 2017. These letters are arriving after consumers have already successfully renewed their coverage or just enrolled for 2017 health insurance. The letters seem to be automatically generated in error as the consumer’s account still show enrollment with tax credits.
Consumers logging into their Covered California accounts hoping to renewal their health insurance may find they have lost their subsidy. Instead of the reduced premium amount they are used to paying, Covered California displays that are not receiving the tax credit subsidy and must pay the full premium amount. A common denominator for consumers who have lost their subsidy is that they had been on Medi-Cal in 2016, but later in the year qualified for Covered California and the Advance Premium Tax Credits to lower their monthly health insurance bill. The transfer of critical application information from Medi-Cal to Covered California is missing, triggering a loss of the subsidy.