Trump Administration Subsidy Results for Washington
Regardless of what’s happening in Washington DC related to changing coverage options, any coverage purchased for 2017 will be good for the rest of the year as long as monthly premiums are paid on time each month. There are no changes to 2017 health insurance available in Washington State.
Open enrollment for 2018 coverage starts Nov. 1. CLICK HERE for Rates which will be available the last week of Oct.
Looking for more information? We recommend the following resources:
Washington State Office of the Insurance Commissioner
Cost-Sharing Reductions FAQ’s
Please know that regardless of what’s happening in Washington DC related to health insurance, any coverage purchased for 2017 will be available for the rest of the year at the same price, as long as customers pay their monthly premiums on time each month. There are no changes to the 2017 health insurance plans available in Washington State.
Q: The press is reporting that federal subsidies for low-income enrollees are ending, what does this mean?
A: Washington Healthplanfinder enrollees may be eligible for two different types of subsidies to help lower costs.
Advanced Premium Tax Credits (APTC) are available for households making up to 400% FPL to help lower the cost of health plan premiums.
Cost-Sharing Reductions (CSRs) are available for households making up to 250% of FPL (more for AI/AN households) to help lower out-of pocket costs.
The administration announced that they will no longer fund Cost-Sharing Reductions. This will not impact consumers in 2017 but may impact eligible consumers in 2018, because carriers will raise rates on silver plans to make up the shortfall.
Q: What are cost-sharing reductions?
A: Simply put, cost-sharing reductions (CSRs) are a discount that lowers the amount you pay for deductibles, co-insurance, and co-payments and other out-of-pocket expenses (like lab tests and prescriptions).
Q: How do I get CSRs?
A: CSRs are available to you if your household meets income eligibility requirements established by the Affordable Care Act. Members of federal recognized tribes also have unique eligibility for these reductions. CSRs are available when you buy a silver plan through Washington Healthplanfinder. Currently, about 70,000 people receive CSRs each month to help lower their health care costs.
Q: How do CSRs get paid?
A: CSRs are funded by the federal government and paid to insurers to reduce the cost for those individuals who qualify when buying a silver plan on Washington Healthplanfinder. The Affordable Care Act (ACA) requires insurers to provide these subsidies to eligible silver plan enrollees.
Q: The Administration announced that they are going to stop funding CSRs. What does that mean?
A: To date, the federal government has been making monthly payments directly to insurers for CSRs. It was recently announced these payments will stop starting in October. Eligible customers will continue to get discounted out-of-pocket services in 2017 – it is required under the ACA. Behind the scenes, in October, November and December insurers will not receive federal payments to compensate them for providing discounted services.
While there is no immediate impact to consumers in 2017, ending federal funding of CSR payments could significantly increase 2018 plan rates for consumers who want to purchase silver plans sold on Washington Healthplanfinder in 2018.
How does that announcement impact Washington Healthplanfinder customers?
Regardless of what’s happening in Washington DC related to changing coverage options, any coverage purchased for 2017 will be good for the rest of the year as long as customers pay their monthly premiums on time each month. There are no changes to the health insurance available in Washington State in 2017.
Q: Where can I get more information on CSRs?
A: You can find more information at www.knowyourplan.org. This site has information about how CSRs work, what they cover and why it is important to consider silver plans that offer cost-sharing reductions.
Open enrollment for 2018 coverage starts Nov. 1. At that time you can shop options at www.wahealthplanfinder.org.
Change takes time. Stay up to date by subscribing to email updates, subscribing to push notification through our mobile app, liking us on Facebook, or following us on Twitter. We are watching federal actions closely and will let you know of any changes and impacts to your options.
Q: For 2018, why would the premiums increase only on silver plans in the Exchange?
A: Since only those enrollees in silver plans sold on Washington Healthplanfinder are eligible to receive the CSR funding, insurers are allowed to apply the cost for those discounts on the silver plans offered on the Exchange.
Q: If silver plan premiums increase, does that impact my tax credit?
A: Yes, and it will go up. This is because tax credits are calculated based on the price of the second-lowest cost silver plan sold through the Exchange in an enrollee’s rating area. For people receiving a tax credit for their silver plan, an increase on all silver plans sold through the Exchange will result in an increase in the financial help you get in paying your premium. This means that the premium increase seen because of the change in who is funding CSRs may be minimized for subsidized enrollees.
Q: When does the administration’s stopping of CSR funding take effect?
A: It will take effect in October 2017. However, current enrollees on the Exchange will not see any increase in their premiums or loss of CSR reductions for the 2017 plan year.
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