Thursday, November 21, 2013

Wait. What?

So I was looking for information about what income levels mean one is thrown into Medicaid and I found a website called “ObamaCare Facts”. I cannot figure out exactly who runs this site: the government, the insurance companies, concerned citizens? It appears to present an uniformly positive view of the Affordable Care Act. Anyhow.

On the page about subsidies, I found this:

A subsidy (cost assistance) lowers the amount you spend on your monthly premium (via advanced premium tax credits) or reduces your out-of-pocket costs for things like copays, coinsurance, deductibles and out-of-pocket maximum (cost sharing reduction).

Subsidies for out-of-pocket costs? Did I know that? A little later, the page says:

Those making less than 250% FPL can get subsidies to lower out-of-pocket costs.

And a little later:

In order to receive out-of-pocket assistance (AKA cost sharing reduction subsidies), you must buy a Silver plan from the state exchange and an individual or family must have incomes no more than 250 percent of the Federal Poverty Line.

Note that in order to receive “out-of-pocket assistance”, one must buy a Silver policy and one must buy if from a State exchange. Of course, this page also says that premium support subsidies are only available if one buys from a State exchange and the Administration is doing its best to make that restriction no longer operative.

I haven’t heard about this type of subsidy but I did find a Kaiser Health News write-up on it and apparently it’s for real for State exchanges.

You learn something new every day.


Grim said...

So are the subsidies generous enough at -250% FPL that it's cheaper to buy a Silver plan than a Bronze or Catastrophic? If so, this is an even bigger wealth transfer than it appears.

Elise said...

I don't know. It should be possible to figure that out and if I get up the energy for another foray into exchange-land, I'll poke around a little.