On Jan. 18, the Trump administration announced the new Health Insurance Marketplaces. The program covers more than 40 million people.
The program is open for enrollment in 2017, and by the end of 2017, the Centers for Medicare and Medicaid Services will develop a plan for the next three years to design the program. On the same day, the HHS released the notice of proposed rulemaking (NPRM), which sets out the standards for the exchange.
For 2017, individuals and small groups will be offered subsidies that range from $1,000 to $2,000, depending on their income and premium cost. Individual subsidies will be available through health plans starting in 2018, and small group plans starting in 2019. Enrollees will pay a monthly fee to access individual plans and a monthly fee to access small group plans.
For 2018, the ACA allows enrollees to use tax credits to help cover the health-related costs of purchasing a bronze or silver plan with a federal subsidy. Tax credits are to be determined by income, and those earning more than 250 percent of the federal poverty level (FPL) will receive up to $7,500. The subsidies will phase out after $10,200.
In 2018, the ACA allowed insurers to offer plans with greater catastrophic coverage to consumers. The regulations do not apply to this type of risk-sharing, and state plans can opt to provide a more limited degree of catastrophic coverage.
The HHS’ proposed rule establishes minimum coverage, and determines how much a person must spend in out-of-pocket payments on medical care as they use their health care coverage.
The proposed rule proposes to allow enrollees to add dependent care and other benefits that are otherwise not permitted under the law without penalty.
What will be the penalties for lack of coverage?
The proposed rule authorizes the Department to establish “medical loss ratio” for the individual market, with a maximum of 25 percent, of an individual’s premium for health services. In a scenario where coverage is deemed unaffordable, individuals will face a penalty equal to the greater of 50 percent of a given family’s household income or 100 percent of the annual family premium.
The proposed rule would allow enrollees enrolled in an individual or small group plan in 2018 to have a hardship exception from this penalty if their household income is below 250 percent of FPL. This exception is to address enrollees who were previously deemed uninsured due to being below the poverty line.
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