The Covid Relief Package offers help with health insurance. Here’s how to get the most out of it


There is something for everyone with private health insurance in the American Rescue Plan Act, but figuring out how best to benefit from it can be confusing.

The $ 1.9 trillion Covid-19 relief bill President Joe Biden signed this month will make coverage much more affordable for millions of people who have market coverage, are uninsured, or have lost their employer’s coverage. In addition, it will eliminate the refund requirements for premium tax credits. Consumers may start seeing these improvements next month, but they may need to go to and update their app for the changes to take effect then.

The new arrangements are temporary; none will extend beyond 2022 unless Congress acts to make them permanent. Many health care advocates hope this will happen.

“If Congress can go back and make these improvements permanent, it will go a long way in making insurance affordable in this country,” said Stan Dorn, director of the National Center for Coverage Innovation at Families USA, a non-partisan advocacy organization. consumer health care. .

In the meantime, these provisions will help Americans obtain or maintain health insurance and ensure economic stability as the country emerges from the Covid-19 pandemic.

What’s new:

Enhanced premium subsidies for market plans

When: 2021 and 2022

Who benefits: Just about everyone who is covered by the Affordable Care Act markets. The cost of premiums for those eligible for grants will drop by an average of $ 50 per month, according to the federal government, but some people will see much greater savings.

Under the ACA, people with incomes between 100% and 400% of the federal poverty line ($ 12,760 to $ 51,040 for an individual or $ 26,200 to $ 104,800 for a family of four people) were eligible for premium tax credits to reduce their premiums for market coverage.

But under the changes in the new law, the amount people owe is reduced at each income level and capped at 8.5% in total.

For example, a single person who earns $ 30,000 per year will pay an average of $ 85 per month in bonuses under the new law for a silver-level plan instead of $ 195, according to an analysis by the Center on Budget and Policy Priorities. . A family of four earning $ 75,000 will pay $ 340 instead of $ 588 per month for similar coverage, according to the analysis.

Everyone benefits from the changes, said Tara Straw, senior policy analyst at the center, including people with incomes above 400% of the poverty line ($ 51,040 for one person) who were previously ineligible. tax credits on premiums.

An older client who is not yet on Medicare “with an income of just over 400% of the federal poverty level in some states would pay 20% to 30% of their income for their health care premium,” said she declared. “Now that will be capped at 8.5%.”

At the other end of the income spectrum, people whose incomes reach 150% of the poverty line ($ 19,140) will owe nothing in bonuses. Under the ACA, they had been required to pay up to 4.14% of their income as a share of the cost of the premium.

Steps to follow now:

  • People who have market coverage in any of the 36 states that use the Federal platform should come back and update their applications and reselect their current plan for new details on their grants starting on the 1st. April.
  • People with market coverage in states that operate their own markets should check the procedures there. States including California and Rhode Island, as well as the District of Columbia, have announced that they will automatically adjust registrants’ premiums.
  • The enhanced tax credit is in effect for the whole of 2021 and 2022. Seek advice from the federal government on how the additional grants will be applied to premiums already paid from January to March.
  • People who do not update their claims now will still be able to claim the additional tax credit amount when they file their income tax return in 2022.
  • More generous premium tax credits can mean people can upgrade to better coverage with lower cost sharing for the same contribution. One potential catch: Plan change can mean that amounts already paid for a deductible under the current plan are lost. Check with the insurer.
  • People who have purchased a 2021 plan in the market, perhaps because their income is too high to qualify for premium tax credits, will need to register for market coverage now in order to get the new bonus tax credits, Straw said.
  • Uninsured people can enroll now during the special covid enrollment period which runs until May 15 on the federal exchange. (Individual states have similar special registration periods.) People who register before April 1 must return after April 1 to update their requests.

Free health insurance for the unemployed

When: 2021

Who benefits: Anyone who received or was authorized to receive unemployment insurance benefits in 2021.

Under the American Rescue Plan, anyone who received unemployment benefits this year will be considered to have an income equal to 133% of the federal poverty line (approximately $ 17,000) for the purposes of calculating the amount they are receiving. must in premium contributions for a market plan. Since people whose incomes reach 150% of the poverty line owe nothing in contributions under the new law, these unemployed people can benefit from a scheme without a premium. If they purchase a silver tier plan, they may also be eligible for cost-sharing discounts that lower their deductible and other out-of-pocket expenses.

Officials are urging those receiving unemployment insurance to enroll in a market plan now to take advantage of the law’s enhanced premium tax credits. The federal government has said it will provide more information this summer on how to receive the additional premium tax credits for people who collect unemployment insurance.

Step to follow now:

  • People who are uninsured or have market coverage can still receive the enhanced premium subsidies described above in the meantime. And because the new law excludes the first $ 10,200 UI from income for the 2020 tax year, people may be eligible for higher premium tax credits based on their more income. weak, Straw said.

No reimbursement of excess market subsidies

When: 2020

Who benefits: People who made more money last year than they estimated when they signed up for Market Coverage.

Under the ACA, people estimate their income for the coming year, and the market estimates how many premium tax credits can be advanced to them each month. At tax time, people balance their actual income with their projected income, and if they have received too many tax credits, they usually have to pay it back to the government.

The new Covid-19 relief bill eliminates this requirement for 2020. The provision could help people who received unforeseen income last year, such as a risk bonus or perhaps who were made redundant and rehired as than an entrepreneur has a higher salary but no benefits, experts said.

Unfortunately, due to the timing of the new law, income tax forms and tax filing software do not reflect these changes, said Sabrina Corlette, a research professor at the University’s Center on Health Insurance Reforms. of Georgetown.

“A lot of people are going to think they owe money, but they won’t,” she said.

Steps to follow now:

  • If you’ve already filed your income taxes for 2020, stay seated. The IRS is reviewing the law and will provide details soon. People shouldn’t be filing amended tax returns at this time.
  • If you haven’t filed a return yet, “some people might want to wait and see if the tax software is updated to allow them to file this adjustment on their tax return,” Straw said. Last week, the IRS announced that the deadline for filing individual federal tax returns for 2020 has been extended this year from April 15 to May 17.

Grants to cover 100 percent of COBRA premiums

When: April to September 2021

Who benefits: People who have lost their employer sponsored coverage and want to keep this plan.

Typically, when people are made redundant and lose their employer’s coverage, they can choose to keep it for 18 months, but they have to pay the full premium plus a 2% administrative fee. This is done under the provisions of a law known as COBRA. Under the new law, the federal government will pay the full COBRA premium until September of this year.

For people undergoing treatment for a medical condition, it may be important to keep their coverage and existing providers. And switching plans mid-year can leave people exposed to a whole new deductible.

But the improved tax credits on newly enacted premiums and free market coverage for people who collect unemployment insurance make market coverage much more affordable than in the past, experts note.

This could be important because after September the new COBRA grants will end and people will be responsible for the entire premium, unless the government sets up a special enrollment period for this circumstance. Without another special registration period, they might not be able to subscribe to a market plan until January.

Steps to follow now:

  • People who missed the initial 60-day enrollment window to maintain their employment-based coverage can go back and enroll in COBRA now. They have 60 days to register after being informed of the new provisions of the covid back-up plan. They will not owe any premiums until their initial eligibility date, but medical claims they suffered prior to enrollment will not be covered.
  • Examine coverage to determine if COBRA coverage or market coverage is the best and most affordable option.

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