The American Rescue Plan Act has something for everyone with private health insurance, but figuring out the best way to get it can be confusing.
The $ 1.9 trillion bill that President Joe Biden signed this month will make coverage significantly more affordable for millions of people who either have market coverage, are uninsured, or have lost their employer coverage. In addition, there are no tax credit repayment requirements. Consumers can see these improvements over the next month, but may need to go to Healthcare.gov and update their application for the changes to take effect.
The Biden Administration increased the amount of time it would take for individuals to enroll in or change federal market plans during a given registration period. The three-month extension means attendees will have until August 15 to sign up and review their options.
The new provisions are temporary; None will extend beyond 2022 unless Congress acts to make it permanent. Many health care advocates hope this will happen.
“If Congress can return and make these improvements permanent, it will go a long way toward making insurance affordable in this country,” said Stan Dorn, director of the National Center for Coverage Innovation at Families USA, a non-partisan consumer health organization.
In the meantime, these regulations will help Americans get or keep their health insurance and maintain economic stability if the country emerges from the covid pandemic.
Improved premium subsidies for marketplace plans
When: 2021 and 2022
Who benefits: Just about anyone who knows about the Affordable Care Act marketplaces. The premium cost for those eligible for subsidies will decrease by an average of $ 50 per month, according to the federal government, but some people will see much larger savings.
Under the ACA, individuals with incomes between 100% and 400% of federal poverty (from $ 12,760 to $ 51,040 for one person or $ 26,200 to $ 104,800 for a family of four) were eligible for tax credits to lower their market coverage premiums .
However, under the changes passed in the new law, the amount of people’s debts at each income level will be reduced and limited to a total of 8.5%.
For example, under the new law, a single person who earns $ 30,000 annually pays an average of $ 85 per month in rewards on a silver plan instead of $ 195. This emerges from an analysis by the Center for Budgetary and Policy Priorities. A family of four earning $ 75,000 pays $ 340 instead of $ 588 per month for similar coverage, the analysis found.
Everyone benefits from the changes, said Tara Straw, a senior policy analyst at the center, including people with incomes above 400% of the poverty line ($ 51,040 for one person) who were previously ineligible for tax credits.
One elderly customer who is not yet on Medicare, “with an income just over 400% of the federal poverty rate in some states, would pay 20% to 30% of her income for her health premium,” she said. “Now that is limited to 8.5%.”
At the other end of the income spectrum, people with incomes up to 150% of the poverty line ($ 19,140) will not owe any premiums. According to the ACA, they had to pay up to 4.14% of their income as a share of the premium costs.
Steps you need to take now:
- Individuals with market coverage in any of the 36 states using the Federal Healthcare.gov platform should re-update their applications and re-select their current plan for new details on their subsidies starting April 1st.
- Individuals with market coverage in states that operate their own marketplaces should review procedures there. States such as California and Rhode Island as well as the District of Columbia have announced that they will automatically adjust the awards of the participants.
- The extended tax credit is valid for all years 2021 and 2022. For premiums paid January through April, consumers can claim these tax credits when filing their taxes next year.
- Individuals who do not update their claims now will still be able to claim the additional tax credit amount if they file their taxes in 2022.
- The more generous tax credits can mean people can switch to better coverage with lower cost sharing for the same contribution. One possible catch: A plan change can mean that amounts already paid under the current plan for a deductible are lost. Check with the insurer.
- Individuals who bought an off-market 2021 plan, possibly because their income is too high to qualify for tax credits, must now enroll in the market to receive the new tax credits, Straw said.
- Uninsured people can now register at the Federal Exchange during the special registration period until August 15. (Individual states have similar specific enrollment deadlines.) Individuals who enroll before April 1 should return after April 1 to update their applications.
Free Marketplace health insurance for people receiving unemployment insurance
Who benefits: Anyone who has been or has been established to be eligible for Unemployment Insurance Benefits in 2021.
The American rescue plan assumes anyone who has received unemployment benefits this year has an income of 133% of federal poverty (about $ 17,000) to calculate how much they owe in premium contributions for a market plan. Since people with incomes up to 150% of the poverty line do not owe any premiums under the new law, these unemployed people can receive a zero-premium plan. When they purchase a silver level plan, they can also receive shared cost reductions that reduce their deductible and other out-of-pocket expenses.
Officials are urging those on unemployment insurance to sign up for a market plan now to take advantage of the law’s improved tax credits. The federal government said the additional savings will be available to people who take out unemployment insurance from early July.
- In the meantime, people who are not insured or have market coverage can continue to receive the increased premium subsidies described above. And because the new law excludes the first $ 10,200 of unemployment insurance from income for the 2020 tax year, people may be able to qualify for higher tax credits based on lower income, Straw said.
No repayment of excess market subsidies
Who benefits: People who made more money last year than they estimated when they signed up for market coverage.
As part of the ACA, people estimate their income for the coming year, and the marketplace estimates how much premium tax credits they can receive each month. At tax time, people reconcile their actual income with their projected income, and when they have received too much tax credit they generally have to repay it to the government.
The new bill to cover covids will remove this requirement for 2020. The provision could help people who received unforeseen income such as risk payments over the past year or who may have been laid off and reinstated as contractors with higher wages but no benefits, experts said.
Unfortunately, due to the timing of the new law, income tax forms and tax return software don’t reflect these changes, said Sabrina Corlette, research professor at Georgetown University’s Center on Health Insurance Reforms.
“A lot of people will think they owe money, but they won’t,” she said.
Steps you need to take now:
- If you’ve already filed your 2020 income tax, you’re stuck. The IRS is reviewing the law and will provide details shortly. Individuals should not file an amended tax return at this point.
- If you haven’t filed already, “some people may want to wait and see if the tax software is updated so they can file that adjustment on their tax return,” said Straw. Last week, the IRS announced that the deadline for filing individual federal tax returns for 2020 has been extended from April 15 to May 17 this year.
Subsidies to cover 100% of the COBRA premiums
When: April to September 2021
Who benefits: Individuals who have lost their employer-sponsored coverage and wish to stick to this plan.
If individuals are laid off and lose their employer coverage, they can generally keep it for 18 months, but must pay the full premium plus a 2% management fee. This is done under the terms of a law called COBRA. Under the new law, the federal government will pay the entire COBRA premium by September this year.
It may be important for people being treated for an illness to maintain their coverage and existing providers. And mid-year changes of plans can leave people on the hook for a brand new deductible.
However, the newly enacted expanded premium tax credits and free market coverage for those taking out unemployment insurance make market coverage much more affordable than in the past, experts say.
This could be important because after September the new COBRA subsidies will end and people will be responsible for all of the premium, unless the government provides a special registration deadline for that circumstance. Without another special enrollment deadline, they may not be able to come up with a market plan until January.
Steps you need to take now:
- Individuals who missed the original 60-day registration window in order to maintain their job-related coverage can now re-register with COBRA. You have 60 days to register after being informed of the new provisions of the Covid Relief Plan. You will not owe any rewards until your original eligibility date, but any medical claims made prior to enrollment will not be covered.
- Check coverage to see if COBRA or market coverage is the best, most affordable option.
KHN (Kaiser Health News) is a national newsroom that produces extensive journalism on health issues. Alongside Policy Analysis and Polling, KHN is one of the three most important operational programs of the KFF (Kaiser Family Foundation). KFF is a foundation that provides health information to the nation.