HEALTH CARE battle reaches Valley
EL CENTRO — Following repeated unsuccessful attempts by Senate Republicans to replace the Affordable Care Act, President Donald Trump decided to take matters into his own hands and signed an executive order on Oct. 12 to end the federal subsidy payments which compensate insurers for providing discounts on deductibles, co-pays and other out-of-pocket costs to low-income consumers.
The actions taken by his administration generated uncertainty and concern for millions of people in the country and more than 1.6 million Californians who rely on the program to afford health care insurance.
However, the state of California anticipated the actions taken by the federal government and put in place a mechanism that will minimize the impact in the short term.
The Affordable Care Act includes two subsidies, the Premium Tax Credit and the Cost-Sharing Reduction (CSR), which Trump is ending payments for.
To prevent a substantial increase in the marketplace plans, Covered California announced last week that silver-tier plans would include a surcharge for next year to keep costs stable despite the uncertainty at the federal level.
“Covered California had anticipated the CSR payments may be terminated – and in an effort to protect consumers and provide stability to the market - we are implementing a CSR-surcharge onto Silver-tier plans for 2018,” said Covered California spokesman James Scullary.
The average CSR surcharge increase on rates is 12.4 percent, although the surcharge will vary for each health insurance company and will range from 8 percent to 27 percent, according to Covered California. Since the surcharge will only apply to the silver-tier plans, Scullary said most Californians would be insulated from the surcharge.
Individuals who do not get financial help and buy individual coverage directly from their health insurance company will not be charged the CSR surcharge.
“Covered California worked hard to come up with a plan that ensures a stable market and protects as many consumers as possible from an unnecessary price hike,” said Peter V. Lee, executive director of Covered California, in a statement. “While some consumers will face higher costs than expected this year unrelated to the CSR surcharge, they can still shop for a better deal to reduce the impact of the surcharge.”
According to enrollment numbers from Covered California, as of March, 10,700 residents of Imperial County were enrolled, with more than 56 percent of individuals enrolled being 45 to 64 years old.
“Cost-sharing reductions help Californians of limited means access the care they need,” Lee said. “This enables Covered California and other marketplaces to provide coverage that truly matters and makes it more affordable for these consumers to see a doctor when they get sick or injured. They also help lower premiums for those who do not receive subsidies by encouraging enrollment of a larger pool of healthy individuals.”
In California, open enrollment begins Nov. 1 and runs through Jan. 31.
“We will still be offering the financial assistance that brings coverage within reach – and if you are uninsured – we encourage people to log onto CoveredCA.com to see if they’re eligible for help,” Scullary wrote. Fallout
Just one day after the White House announcement, the attorneys general of 18 different states, including California, sued the administration in order to keep the subsidy payments in place.
The lawsuit alleges that actions from the federal government are a deliberate attempt to sabotage the ACA.
The Trump administration has argued the subsidies are illegal because Congress never appropriated the money for them, however, Congress could still act to maintain the payments.
Along with the plan in place at the state level to protect consumers from the uncertainty, a group of Senators from both political parties have come together to sponsor a bill that would ensure the federal government continues to make such payments in order to avoid premiums getting more expensive for some of the people who need them the most.
Earlier this week, Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.) said they had reached a bipartisan deal that would extend payments to insurers under the Affordable Care Act.
Despite still being a long way from becoming a reality, on Thursday, Alexander announced that in total 12 Republican and 12 Democrat senators signed onto the bill, which would continue the subsidies for two years and give states more flexibility to waive ACA rules.
The Hill reported that amid the decision to end the subsidies, states like Pennsylvania would be severely affected. The state was anticipating an average increase of 7.6 percent in premiums for 2018, however, with the proposed cuts to the subsidies, the rates are now expected to increase by an average of 30.6 percent.
For more information on California insurance go to www.coveredca.com