Health Insurance Subsides 2019: Are They Still Available?

Affordable Care Act

Health Insurance Subsides 2019: Are They Still Available?

Updated on October 31, 2019

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Can I still get a healthcare subsidy in 2019?

The answer is yes!
It’s important to understand that there are two different kinds of subsidies out there, and they operate in different ways.
First off, both of the types of Obamacare subsidies in 2018 both still rely on federal poverty guidelines (FPL). In order to receive these subsides you must earn between 100% and 400% of the FPL. If your household incomes is 401% or above, you will not qualify for these subsides..
For 2019 the federal poverty guidelines are as follows:

Household Size100% of the FPL400% of the FPL
1$12,490$49,960
2$16,910$67,640
3$21,330$85,320
4$25,750$103,000
5$30,170$120,680
6$34,590$138,360
7$39,010$156,040
8$43,430$173,720

Source: 2019 HHS FPL guidelines published in Federal Register


Cost-sharing reduction (CSR) payments

The CSR subside faced some changes in 2017. These Obamacare subsides are only available to families earning 250% and bleow the FPL. These subsides help lower the amount you have to pay for deductibles, copayments and coinsurance.
CSR payments are also referred to as “extra savings”
If you qualify for extra savings, you must enroll a silver plan. You will also have a lower out-of-pocket maximum, which help control how much you spend on healthcare before your insurance kicks in. Once you’ve reached this maxiumum, your health insurance will cover 100% of the cost of all covered care.
You also may be elligable for more cost-sharing reductions if you are a member of a federally recognized tribe or are an Alaska Native Claims Settlement Act (ANCA) Corporation shareholder.

Advance premium tax credits (APTC)

This Obamacare subsidy is still around in 2018 and hasn’t seen any changes since its inception. These credits are made available to people earning 400% or less of the FPL..
These subsidies are what most people know about, maybe because they deal with one of the most important costs associated with health insurance plans: the monthly premium. Your plan’s premium is the set cost you’ll be required to pay every month in order to continue being covered under your plan.

What has changed about CSR subsidies?

In compliance with President Trump’s executive order signed on October 12, 2017, the government will no longer pay for cost-sharing reduction subsidies (but APTC subsidies will still be funded by the government for now).
What most people don’t understand is that the government pulling out of CSR subsidies doesn’t affect them directly. Under the Affordable Care Act (ACA) insurance companies are still legally required to offer CSR subsidies to those who qualify.

How is this going to affect the health insurance market?

Although people still have access to CSR subsidies, it doesn’t mean that prices will stay the same. The cost increases will likely reach customers through a trickle effect.
As the Kaiser Family Foundation reports, insurance companies have built this loss into the prices of their plans for the 2018 open enrollment—meaning while both subsidies are still available,  we will likely see a hike in plan prices, since the insurance companies are having to make up for less help from the government.
No one can say for sure how one thing or another will affect the entire health insurance market. The trends of prices depend, in part, on the people buying them, and people are not always as predictable as we want them to be.
If you are planning on purchasing a plan or changing your coverage during the 2019 Open Enrollment Period for coverage beginning in 2020, make sure to check eHealth for more updates surrounding the health insurance market.

We’ll let you know when we publish anything new.