Basic Health Plans Threatened By Federal Cuts

Since President Trump and the Department of Health and Human Services cut cost-sharing reductions in October, some states have brought a lawsuit against the government. The lawsuit centers on the loss of federal funding, which jeopardizes basic health programs.

The Basic Health Program offers an alternative coverage plan for people with household incomes between 133 and 200 percent of the federal poverty level. The ACA included this as an option to make coverage more affordable. New York and Minnesota were the two states in which these programs were offered in order to provide a “standard plan” for those who didn’t qualify for employer coverage or other government programs. It is estimated that they offer comprehensive coverage for more than 800,000 low-income people.

The attorneys general of New York and Minnesota filed the suit against the government for over $1 billion a year lost from funding the basic health programs. The two states estimate that New York will get about $1 billion less funding in 2018 to run its Essential Plan, and Minnesota will get about $130 million less to run MinnesotaCare.

“The abrupt decision to cut these vital funds is a cruel and reckless assault on New York’s families — and we will not allow it,” state Attorney General Eric Schneiderman said in a statement trumpeting the suit. “I won’t stand by as the federal government continues to renege on its most basic obligations in a transparent attempt to dismantle the Affordable Care Act.”

“For each dollar Minnesota sends to Washington, D.C., we get just 53 cents back,” Minnesota Attorney General Lori Swanson said in a statement. “This lawsuit seeks to avoid Minnesota losing hundreds of millions of dollars of payments in the coming years.”

The administration told the states it would stop paying the “cost-sharing reductions component” of the basic health program funding, but continue to pay premium tax credits.

The two states have submitted proposals to restore the funding, but the Department of Health and Human Services failed to answer, and never considered the proposals. Because of this, the two states are asking a judge to intervene in order to force the government to pay the full federal funding.

The fear amongst the two states is that if the federal funding is not restored, and then costs will rise and coverage will shrink. “It could trigger major changes to the eligibility structure, the benefits or increases in premiums,” says Maureen O’Connell, president of Health Access MN, which helps people enroll in marketplace coverage.

Double Check Your 2018 Information Now!

When enrolled in a Marketplace Insurance plan, it is important to make sure your household information is up to date every year. There may be benefits you are missing out on and possible consequences if you do not update.

What Changes To Report

  •         Changes to your income for the year, whether a raise or demotion
  •         Changes in health coverage: Whether someone in the household is getting job-based insurance, and/or receiving public coverage such as Medicaid, CHIP, or Medicare. Also, if someone is losing coverage that is job-based or public.
  •         Changes to your household or individual members:  If there is a birth or adoption, placement of a child for adoption or foster care. If someone becomes pregnant, and/or getting married or divorced. Child turning 26 years old. If there is a death, gaining or losing a dependent, and if you are moving to a permanent address.
  •         Make sure names, date of births, and Social Security numbers are correct
  •         Changes in status: Such as disability status, tax filing status, change in citizenship, whether there is American Indian member, and/or incarceration or released from incarceration.

Why You Should Report The Changes

If your income goes down or you gain a household member, then you may qualify for more saving than you are currently receiving. This can lower your monthly premium payments.

The flip side is if your income goes up or you lose a household member, then you could qualify for fewer savings. If you do not report this change, it will result in owing money when you file your federal tax return.

How To Update

Who you will contact for help is dependent on whether you got your plan from the Marketplace, or from a provider such as EZ.Insure. If you got a plan from one of our agents, you can always call 855-220-1144, or email us at [email protected] to speak to your agent and update your information.

  •         You can report any change by updating your application online after logging into your account on Healthcare.gov. Click on your application, choose “report a life change,” and then save it when done.
  •         Contact a representative at the Marketplace Call Center at 1-800-318-2596. Or call your advisor at EZ.Insure.
  •         If you move to a different state, log onto your account in HealthCare.gov, select a new application; select the year for coverage, and the new state. Finally, choose “apply or renew” to start a new application.
  •         If you are switching to a job-based insurance plan, or to Medicare, make sure to cancel your current plan.

Do not forget to update your 2018 information, because it can cost you in the end when you file your federal tax return. And more importantly, you can possibly lose out on extra savings you should be receiving!

If you are looking for a new plan or have questions regarding your coverage, EZ.Insure can help. Our agents specialize in short term plans in your area and can answer any questions you have to find out if it is right for you. You will be given your own advisor who will go over different plans, and help sign you up free of charge. To start saving, enter your zip code in the bar above to get instant quotes, email us at [email protected], or call 855-220-1144. We guarantee we will be able to find you a plan that is affordable and meets your needs.

Legal Challenges Ahead For ACA

The Affordable Care Act is once again facing a new challenge, this time by Republican states trying to dismantle it once and for all. The basis of the claim filed is that since the individual mandate was removed, it makes the whole ACA unconstitutional. The individual mandate is the ruling that people must have insurance or sign up for it within an amount of time or they would face a penalty fine during tax season.

Ever since President Trump was elected, one of his goals was to repeal and replace the Affordable Care Act which was signed into law by President Obama in 2010. One of the provisions of the ACA, the individual mandate, has been challenged by Republicans since 2012. They claimed it was an unconstitutional expansion of the government’s power. However, the Supreme Court upheld that the individual mandate tax was the government’s right. Chief Justice John G. Roberts Jr. stated the government “does not have the power to order people to buy health insurance, but it does have the power to impose a tax on those without health insurance.”

In December 2017, President Trump came one step closer to dismantling the ACA by ridding the mandate. His administration was able to change the individual mandate penalty to $0 beginning January 1, 2019. Because of this, as of February 26, 2018, Texas Attorney General Ken Paxton and 19 other states filed a lawsuit stating, “the country is left with an individual mandate to buy health insurance that lacks any constitutional basis. . . . Once the heart of the ACA — the individual mandate — is declared unconstitutional, the remainder of the ACA must also fall.”

In one of the cases against the ACA, King v. Burwell, Chief Justice John G. Roberts Jr. noted that  “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible we must interpret the Act in a way that is consistent with the former and avoids the latter.”

Judge Reed O’Connor will be hearing the case filed by the Texas Attorney General and other states. O’Connor was appointed by President George W. Bush in 2007 and has ruled against the ACA in past cases.

This is all happening during the time insurers must figure out the pricing for next year’s premiums and rates so they can file it with state regulators. Insurers are concerned because they do not know how much to raise rates if they will charge the same price to healthy and sick people, or whether to pull out of the marketplace.

While the marketplace in in panic about how much their prices should go up and if they will even still be in business, it is smart to seek quotes and plans from private insurers. EZ.Insure is able to provide you with affordable plans with ease. We offer the stability of insurance within your region by one of our highly trained and educated agents. To receive a quote, call 855-220-1144 to speak your own advisor, enter your zip code in the bar above, or email us at [email protected]. We will provide quotes and offer our help free of charge without hassle.

Cheaper Short Term Plans Can Now Last Up To 3 Years

The Trump Administration has finally finalized expanding insurance companies ability to sell short-term health insurance plans for up to 3 years (36 months). This will allow consumers to buy less expensive and less comprehensive insurance policies for a longer time. The old rule for short-term health insurance was that it cannot last for more than three months. This new rule will open these policies to consumers for up to 36 months, in hopes that more healthy people will utilize them. These plans may offer less coverage, but will be there for those who can not afford or do not feel that they need extensive coverage.

“We want to open up affordable alternatives to unaffordable Affordable Care Act policies,” said Health and Human Services Secretary Alex Azar. “Americans need more choices in health insurance so they can find coverage that meets their needs. The status quo is failing too many Americans who face skyrocketing costs and fewer and fewer choices. This is one step in the direction of providing Americans health insurance options that are more affordable and more suitable for individual and family circumstances.”

In 2016, Obama restricted these plans by limiting them to just three months of coverage from 12 months.  Back in October, Trump issued an executive order to cut back the restrictions on these plans that limited them to three months. By removing these restrictions, Trump gave the public the ability to decide for themselves whether they need a more committal plan, or a short term plan for the next year. This is one of Trump’s first steps to achieving his promise of dismantling the ACA once and for all.

Some skeptics worry that the more healthy people leave the marketplace, the more expensive premiums will be for those still in the market. The premiums would increase and cause subsidies for policyholders to rise which in turn would cost the government more money.

When asked about the concerns that the proposed rules would destabilize insurance markers Seema Verma, the administrator of the federal Centers for Medicare and Medicaid services said, “we don’t think there’s any validity”. She continued to state that federal officials believe that between 100,000 and 200,000 healthy people now buying insurance through those federal exchanges would switch to the short-term plans, as well as others who are now uninsured.

Once someone signs up for a short term plan for a year, they can now continue to renew it for up to three years. Insurers can ask medical questions and possibly reject consumers due to pre-existing conditions for a short-term policy. Once approved for the plan, if a consumer develops a ‘pre-existing condition’, then they can be rejected when it is time to renew.

Short term plans do not cover maternity care, so if you are considering getting pregnant you should take into consideration how much out of pocket costs you can handle.

Short term plans are less expensive, because they cover less, for example, maternity care and preventative care are not covered. It is ideally for those who are relatively healthy and do not need a lot of coverage. The hope is that the new rule will be more appealing for younger and healthier people.

The Trump Administration believes this will bring in an increase in premium revenues and profits because more people would sign up for a short-term insurance plan. This will allow the insurers to set prices to reflect a customer’s health risk of high medical costs. Trump believes that this 36 month extension is important because premiums more than doubled from 2013-2017 for health plans in the federal Marketplace Insurance exchange.

If you are looking for a short term plan or have questions regarding it’s coverage, EZ.Insure can help. Our agents specialize in short term plans in your area and can answer any questions you have to find out if it is right for you. You will be given your own advisor who will go over different plans, and help sign you up free of charge. To start saving, enter your zip code in the bar above to get instant quotes, email us at [email protected], or call 855-220-1144. We guarantee we will be able to find you a plan that is affordable and meets your needs.

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