American Rescue Plan: What Does it Mean for Your Healthcare?

On March 11, 2021, President Joe Biden signed the $1.9 trillion American Rescue Plan, with benefits to help Americans affected by the pandemic. Specific health care provisions include new and expanded financial help to benefit an estimated 3 million Californians.

More than 9.5 million workers have lost their jobs in the wake of the pandemic, with 4 million out of work for half a year or longer. The plan will help people in need in many different ways. We share how it will affect health insurance beneficiaries if you are currently uninsured,  a CoveredCA subscriber, Medi-Cal recipient, or an off-exchange (private) member.

This new care act will help lower monthly healthcare costs, to make healthcare more accessible and affordable for many Californians now. It will also allow many more to be covered and help them save on their premium costs. Covered CA hopes to get as many uninsured people, insured as possible.

Three categories of people benefit from this act:

• Individuals who are currently uninsured and are eligible for the new financial help through Covered California, with many qualifying for $1 dollar health plans.
• Individuals who are currently have health coverage directly through an insurer outside of Covered California and are now eligible for financial help for the first time. These consumers may be able to save hundreds or even thousands of dollars by switching to the same or similar health coverage through Covered California.
• Individuals who are currently insured in Covered California health plans and are now eligible for more financial help.

Why it’s imporant to reach out to your existing clients and prospects about the ARPA subsidy expansion – Right now, state exchanges and the federal exchange are doing outreach (emalls, ads, marketing, etc.) Letting everyone know that 1. SEP has been extended, and 2. Members and non members can apply for coverage, change plans, or re-apply on the same plan to see if they qualify for the new subsidy. What they are NOT doing is advising these members/clients to refer back to their agent. Instead, they are telling people to come to their website and apply for coverage direcly.

What is it – ARPA subsidy was recently signed into law, increasing and expanding eligibility for ACA premium subsidies, as well as COBRA updates!

What Changed

Primarily it affects those between 100% - 150% FPL and those making over 400% FPL.

FPL  - Before, someone at 100% FPL (single person, $12,880) would still have to contribute 2.07% of their annual income towards monthly premium, and 4.14% of their annual income for those at the 150% FPL mark. Now, those earning up to 150% FPL will have fully subsidized, $0 dollar plans, and even premium free Silver plans.

Over 400% - Those making over 400% FPL (single person, roughly $51,040 annually) will pay no more than 8.5% of household income which significantly helps the higher age consumers. For example, say, a 24 year old, making $51,000 a year, their premium for a bronze plan might cost less than their 8.5% threshhold (i.e. they might be paying less than $4338 for the year for their plan because of their age.) However, on average, a 64 year old, normally paying $8,349 annually for their health plan, they would pay no more than 8.5% of their income. If they make $51,167 (401% FPL) annually, they would pay no more than $4,394 annually for the same coverage; essentially cutting their premium in half.

✅ Covered California is opening a new special-enrollment period on Apr. 12 that runs through Dec. 31, and consumers can see savings reflected on their monthly health care bills as soon as May 1 if they enroll by Apr. 30.

✅ Consumers at any income level may be eligible for more financial assistance.

✅ Consumers who enroll in Covered California health plans will not have to pay more than 8.5% of their household income for a benchmark plan.

✅ Individuals who are currently uninsured and are eligible for the new financial help through Covered California, with many qualifying for $1-dollar health plans—including some Silver plans.

✅ Consumers who earn more than 400% of the Federal Poverty Level may be eligible for federal financial help for the first time.

✅ Consumers currently insured off-exchange may save hundreds or even thousands of dollars by switching to the same or similar coverage through Covered California.

✅ Most current on-exchange members (Covered CA) subsidies automatically redetermine to maximize their savings.

✅ The Medi-Cal income threshold was updated recently for 2021 and has gone up to $17,775 for individuals and $36,570 for families of four. If you now fall under this threshold, please contact us before April 12, as you will qualify for Medi-Cal benefits!

✅ Consumers receiving unemployment compensation during 2021 may be eligible for the maximum amount of subsidies if enrolled in Covered California plans.

✅ If you are not currently receiving subsidies today, please contact our Covered CA StoreFront team. We will ensure that your applications are updated with current income and determine if you are eligible.

✅ If you are in any of these categories, we recommend that you connect with us as soon as possible to make sure you are not missing out on potential financial help.

The reduced health care premiums under the American Rescue Plan will remain in place for all of 2021 and all of 2022, unless Congress extends or makes these provisions permanent.

Covered California health plans cover:

✅ COVID-19 vaccinations and testing, as well

✅Any medical treatment necessary due to COVID-19 at no charge or minimal co-payments.

✅ All plans must offer essential benefits under the Affordable Care Act, ranging from maternity care and hospitalizations to preventive and mental health care.

✅ No-cost preventive health care includes annual checkups with your doctor and screenings for diabetes, cancer, and high blood pressure.

Remember to stay healthy! We are responsible for our health. Health starts with walking 10,000 steps per day, drinking lots of water, green tea, eating lots of greens, having positive thoughts, spending time in stillness, and scheduling our annual physical, women wellness exams, and a Colonoscopy. A little concern for our health, goes a long way.

Much love from Naama & the A+ Team