Open enrollment hasn’t started yet and this is my second bulk email to help provide clarity about 2018. On October 13th news outlets are reporting that the Trump order will eliminate subsidies.  This is a complete falsehood.

In May of 2016 a Federal court ruled that Cost Sharing Reduction payments (CSR’s) to insurers were not legal. CSR payments to insurance companies are payments that offset the loss to insurers for offering reduced deductible, coinsurance and copays to certain low income individuals who buy Silver level plans.  This payment to the insurers is completely separate from the Advance Premium Tax Credit payments, commonly referred to as Subsidies, or APTC’s. that reduce your premium.

The court rulings impact has been deferred since May 2016 by both the Obama and Trump administration. Why its impact was deferred since May of 2016 is a much longer story.  The deferral of the ruling is over. As a result, the Federal Government will no longer make monthly payments to health insurers beginning as soon as October 20th.  These payments were billed by the insurers to the Federal Government to provide reduced deductible, coinsurance and copays to lower income individuals.

This order has no impact on reduced premium subsidies now or in the future.  It does not impact your coverage or your premium.

Why is this news?

Under the law, insurers are to provide lower deductibles and out of pocket maximums to those with income between 138% and 250% of poverty level.  This is an unfunded demand to insurers.  They are not allowed to charge more money for the coverage. The money has to come from somewhere.  It will come from those who will pay more and are full pay customers.  Unless there is a court challenge, lower income individuals will still receive lower deductibles and copays in 2018.

Most carriers across the country offering individual coverage on the exchange had already built in to 2018 pricing the loss of these federal payments.  Specifically, Blue Cross of Illinois and Health Alliance did.  So for those in Illinois this is not a major news event but it could clear the path for future changes.

If you want the actionable truth about what is happening with health insurance, we encourage our clients to get their news from us instead of late night TV.

Open Enrollment to start NOV 1st and Ends DEC 15th.

As of the writing of this email to you, we as agents still do not have the outlines and pricing for 2018 coverage. We will send out a bulletin to all of our clients when we have additional information is available.

If you do something independently on the exchange, please be sure and name us as your agent.  We appreciate your support.

Mark Gurda: ID: castlegroup, NPN 1486813
Mark Zisook:  ID: Zizkid, NPN 52549
Jeff Greenberg: ID: jeffgr30, NPN 1919871

Thank you for your business and your referrals.