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.
Covered California has updated their online application and enrollment program to allow families receiving premium assistance to select different metal tier levels and health plans for each household member. Previous to this update, only households who enrolled without qualifying for premium assistance could split the family member up between different plans. Beginning August 1, 2016, families receiving Advance Premium Tax Credits to reduce their monthly health insurance bills will have more consumer choice.
Blue Shield has been sending confusing letters to their members that seem to indicate that the individual or family has lost their Covered California subsidy and they will now have to pay the full premium amount. These premium rate scare letters are automatically generated and do not necessarily reflect the full premium amount will be the consumer’s responsibility. Unfortunately, these confusing letters are throwing consumer’s into a panic generating phone calls to Covered California, Blue Shield, and insurance agents.
Some individuals and families who enrolled through Covered California have received a letter notifying them they are at risk of losing financial assistance in 2016. The letters being sent out include three reasons why a household might lose the premium assistance to lower their monthly health insurance bill. They are also frightening consumers who actually compiled with all the conditions they list in the letter.
KFF has develop this simple calculator to help people determine if they are eligible for a subsidy or advance premium tax credit for their health insurance costs. The calculator will work for all fifty states, but is not a replacement for the actual federal or state exchange where you reside.