The Trump Administration’s
efforts to kill the Affordable Care Act have sown confusion among many Americans who rely on the so-called Obamacare marketplace for health coverage.
The Trump Administration’s efforts to sunset the Affordable Care Act have sown confusion among many Americans who rely on the so-called Obamacare marketplace for health coverage.
President Donald Trump issued executive orders on Oct. 12 to stop federal payments for some subsidies and encourage the expansion of low-cost health plans that lack basic coverage guarantees under the act.
Insurance companies will offer coverage plans starting Nov. 1.
A majority of the 1.4 million Affordable Care Act consumers in Florida will continue to qualify for government subsidies and will pay no more for premiums and out-ofpocket costs than they paid in 2017, according to state and industry officials. Some might pay less, they said.
Others will continue to receive subsidies to help reduce premium costs even if they aren’t eligible for help for out-of-pocket costs. That group will see modest premium increases.
A third group — about 7 percent of on-exchange Silver plan purchasers — will see premiums jump sharply because they are not eligible for government subsidies. When the enrollment period begins, insurers offering plans in Florida for 2018 will encourage those consumers to switch to comparable plans with lower price increases.
Last summer, state insurance regulators anticipated that Trump might stop paying out cost-sharing reductions to cover some out-ofpocket expenses. State regulators directed insurers to increase rates for on-exchange Silver plans that qualify for cost-sharing subsidies by 31 percent over the increases previously requested. For Florida Blue, those previous increases ranged from 7 percent to 12 percent, according to Penny Shaffer, Florida Blue’s South Florida region market president.
Basically, the government took away one pot of money but will have to dig into another pot of money to make up the difference. A study by the nonprofit Urban Institute predicts the government will spend 11 percent more in Florida subsidizing enrollees because of Trump’s action.
Enrollees who don’t qualify for premium tax credits or cost-sharing reductions will pay a lot more if they remain on the exchange. But insurers are creating off-exchange Silver plans with virtually the same provider networks and benefit selections minus the 31-percent rate increases designed to preserve cost-sharing subsidies.
The 7 percent of on-exchange enrollees who don’t qualify for assistance will need to transition to the new off-exchange plans like tens of thousands of other individual plan enrollees, Shaffer said. The company’s off-market plans are ACA-compliant, so “there’s no reason for them to stay on-exchange,” she said.
At Florida Blue, just 66,000 of roughly 1 million on-exchange enrollees don’t qualify for any kind of subsidy, she said. The company is concerned some of them won’t bother to select a new off-exchange plan and will be automatically reenrolled at a much higher price.