Breaking down the bipartisan health deal

Latest proposal would offer choice, preserve ‘essential’ benefits and may result in tax breaks

The Obamacare roller coaster ride continued this week with a bipartisan effort to make short-term fixes to the insurance marketplaces.

On Tuesday, Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., said they had reached a deal to shore up Obamacare insurance markets by guaranteeing federal subsidies for low-income insurance customers for two years.

On Wednesday, President Trump tweeted that he didn’t like it, and GOP support began evaporating.

Here’s what you need to know about how the latest plan could affect you, if Congress and the president pass it.

IT PROBABLY DOESN’T AFFECT YOUR INSURANCE

Only about 7% of the population buys insurance on their own, instead of getting coverage through an employer or government program such as Medicare or Medicaid.

Contrary to what most people think, those are the only ones whose insurance is affected by changes to the Obamacare marketplaces.

But if you do buy your own insurance ...

PREMIUMS COULD EVENTUALLY BE LOWER

Insurance companies are required to give discounts to lowerincome customers on deductibles and co-payments for marketplace plans, and the federal government has been providing subsidies to insurers to offset those costs. The Alexander-Murray plan would extend those subsidies for two years.

MORE PEOPLE COULD CHOOSE LOW-COST PLANS

The deal would let anyone in the individual market buy plans with low monthly premiums and very high deductibles — more than $7,000 for this year’s catastrophic plans.

Currently, only adults up to age 30 and those who qualify for a “hardship waiver” can buy them. Increasing that option could draw healthier people into the insurance pool, which could eventually decrease the cost for sicker customers.

STATES COULD COME UP WITH NEW OPTIONS

It could become easier for states to get around the Affordable Care Act’s insurance rules. States could not undermine protections for people with pre-existing conditions or eliminate essential health benefits, according to an analysis by health care experts Billy Wynne and Timothy Jost.

But the proposal would let states make changes to insurance requirements as long as the options have “comparable affordability” to ACA plans.

That is a little more forgiving than the current requirement that plans be “as affordable as” ACA coverage.

MORE PEOPLE COULD HAVE A CHOICE OF PROVIDER

Uncertainty about whether the federal government would continue to reimburse insurers for cost-sharing subsidies prompted many insurers to stop participating in the marketplaces.

It’s too late for insurers who have withdrawn for 2018 to jump back in. But continuing the payments through 2019 could prevent more from leaving, and potentially lure some back.

SOME TAXPAYERS COULD COME OUT AHEAD

The subsidies that the plan would continue through 2019 end up saving the government money overall, according to the nonpartisan Congressional Budget Office.

That’s because if insurers raise premiums to offset the loss of the payments, the government ends up paying more in the tax credits available to low-income people for their premiums.

Contrary to what most people think, only those who buy insurance on their own will be affected by changes to ACA marketplaces