Fix for Affordable Care Act's "family glitch" on the horizon

[Greenbeard]

Big, if true!

The ACA's political and policy success has always hinged on its ability to improve the situations of more Americans. To its credit, the Biden administration has recognized this and leaned in hard toward making better coverage more easily accessible at lower cost than ever before, leading to the sharp uptick in coverage in just the past year.

But for the past decade an errant word in the text of the law, generally recognized to have been a drafting error, has made it harder for families to opt out of overly expensive employer-offered coverage and instead qualify for financial assistance to shop on their own in a marketplace. Looks like Biden is getting a step closer to finally addressing the problem.

Fix for Affordable Care Act's "family glitch" on the horizon

The Biden administration is reviewing a regulation that experts expect would help close the Affordable Care Act's "family glitch," according to a notice filed last week.

Why it matters: The regulation could help as many as 5.1 million people get more affordable coverage by addressing an ACA loophole.

Details: The family glitch was created by a provision of the ACA that deals with premium subsidy eligibility — and that lowballs the cost of covering a family.

• People who are eligible for "affordable" employer health insurance aren't eligible for premium assistance on the ACA marketplaces. Affordability is defined as the premium for a single beneficiary — the employee — being below a certain percentage of family income.
• That doesn't account for the additional costs of adding dependents to the plan. But the affordability determination is applied to all members of the household, making them all ineligible for subsidies if the premium for just one person falls below the threshold.

What they're saying: "Fixing the ACA's family glitch may be the most consequential thing the Biden Administration could do without Congress to make health insurance more affordable," KFF's Larry Levitt tweeted Tuesday.

 

[lemmiwinx]

If it's not free who would in their right mind would sign up for it? Playing games about making it cheaper I don't get.

 

[Greenbeard]

If it's not free who would in their right mind would sign up for it? Playing games about making it cheaper I don't get.

Plenty of people buy health insurance despite it not being free.

 

[ttwtt78640]

A feature (glitch?) that I would like to see fixed is the need for Medicare participants to pay an endless ($75/year of opt out) penalty for having declined to initially opt to have Part D coverage if (when?) they elect to add a Medicare advantage plan.

If someone (like me) opted out of Part D for one year, then they must pay a $75 annual penalty for life. If someone (like my girlfriend) opted out of Part D coverage for two years, then they must pay a $150 annual penalty for life. I can see having to pay back their Part D opt out “savings” once, but it seems ridiculous to have to do so annually.

 

[Mach]

Health insurance in the U.S. is such a disgusting game.

I pay around $20K for family insurance, and now that I'm basically retired, I can't get coverage unless I go to the marketplace. Thankfully it's there, what did people with pre-existings use to do? Self-insured?
But the kicker is that I pay about as much for an HMO on the marketplace as I did for my PPO (which I'd prefer). Why can't they offer PPO reasonably on the marketplace? Insurance ultimately aggregates everyone in their pool anyway, why discriminate vs individual and small business so dramatically? It's just sad.

That said, if it was all HMO, it would probably be cheaper for similar coverage due to cost savings across the county...a silver lining. As it is, its kind of worst of both world.

 

[BirdinHand]

If it's not free who would in their right mind would sign up for it? Playing games about making it cheaper I don't get.

For health insurance?

Unless you have an amazing employer or qualify for Medicaid, or a fully subsidized plan on the exchange - then anyone who has health insurance pays for it in the US (until Medicare age - but then that’s deducted from Social Security)

 

[PeacefulWarrior]

Good for everyone, although with my 100% FREE Socialist BidenCare™ plan I'm already well taken care of heh heh heh. Good thing too, just made an appointment with my GP for tomorrow since I think I might have an infection going on, then next Tuesday I have a trip to the dermatologist, then Wednesday its back to the Cardiologist for my INR, and then a week from then its back to therapy. And in April I have a heart echo followed by ANOTHER appointment with the Cardiologist for the interpretation/evaluation.

Its a lot to juggle, and I dont think theres anything serious going on right now, but if there is it sure is nice to know I'm 100% COVERED for any treatments needed and its FREE!

god bless President Joe Biden Greenbeard.....god bless Him!!!!💯💯💯
Just mailed in a federal tax return yesterday....got a big $0 in income last year <smirk>, hell tbh I dont plan on working again ever as long as I have my BidenCare™!!!

Thank you Mister President....SIR!!!!

 

[PeacefulWarrior]

Thankfully it's there, what did people with pre-existings use to do? Self-insured?

For 15 years I paid EVERY DIME of everything I got, straight out of my wallet. And it wasnt cheap, I have a prosthetic heart valve, every time I felt sick or needed something I had to ask "Gee, should I go to a doctor? How much is this going to cost me now?"

Sure is nice to not have to worry about that right now, I think to myself "Wow, is this how it is in more enlightened nations? You just walk in and get what you need?"
The USA is a freaking SCAM. All geared toward insurance companies making profit off the sick. Its downright evil imo. Screw that, I dont feel bad at all about my FREE BidenCare™.

 

[Greenbeard]

Health insurance in the U.S. is such a disgusting game.

I pay around $20K for family insurance, and now that I'm basically retired, I can't get coverage unless I go to the marketplace. Thankfully it's there, what did people with pre-existings use to do? Self-insured?
But the kicker is that I pay about as much for an HMO on the marketplace as I did for my PPO (which I'd prefer). Why can't they offer PPO reasonably on the marketplace? Insurance ultimately aggregates everyone in their pool anyway, why discriminate vs individual and small business so dramatically? It's just sad.

That said, if it was all HMO, it would probably be cheaper for similar coverage due to cost savings across the county...a silver lining. As it is, its kind of worst of both world.

When the marketplaces first opened, a decent chunk of offerings were PPO products. That number has steadily dwindled since then as they proved unattractive for most buyers and sellers. For buyers because people turned out to be quite price sensitive in shopping on the marketplaces and PPOs tend to be more expensive. And for sellers because they tend to attract sicker patients, often pay higher reimbursement rates to providers, and provide less ability to manage care and costs (all of which are what tend to make them higher-premium and thus less attractive options for most buyers).

 

[HangLow]

Big, if true!

The ACA's political and policy success has always hinged on its ability to improve the situations of more Americans. To its credit, the Biden administration has recognized this and leaned in hard toward making better coverage more easily accessible at lower cost than ever before, leading to the sharp uptick in coverage in just the past year.

But for the past decade an errant word in the text of the law, generally recognized to have been a drafting error, has made it harder for families to opt out of overly expensive employer-offered coverage and instead qualify for financial assistance to shop on their own in a marketplace. Looks like Biden is getting a step closer to finally addressing the problem.

Fix for Affordable Care Act's "family glitch" on the horizon

​

 

[bave]

Always the plan to get more people on welfare programs, never get people off them.

 

[Neomalthusian]

A lot of bafflingly stupid replies to this topic.

"Health insurance is a scam!"
"Thanks a lot Biden!"
"Government sucks!"
"Insurance is evil!"
"Everything is welfare!"

I don't think anyone even read the topic or has any idea what it's about.

 

[Deuce]

If it's not free who would in their right mind would sign up for it? Playing games about making it cheaper I don't get.

What? Health insurance isn't free. It doesn't grow on trees.

 

[Greenbeard]

With Obama's help, Biden announces proposed fix to ACA's 'family glitch'

President Joe Biden announced a fix to Obamacare's "family glitch," to make more dependents eligible for the ACA premium subsidies.

www.usatoday.com