Eligibility and Determination of Health Insurance Premium Tax Credits and Cost-Sharing Subsidies PDF Download
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Author: Bernadette Fernandez
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Certain individuals without access to subsidized health insurance coverage may be eligible for premium tax credits, as established under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). This report examines these tax credits and their eligibility requirements, as well as cost-sharing subsidies.
Author: Bernadette Fernandez
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Certain individuals without access to subsidized health insurance coverage may be eligible for premium tax credits, as established under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). This report examines these tax credits and their eligibility requirements, as well as cost-sharing subsidies.
Author: Brittany Rodriquez
Publisher:
ISBN: 9781634829328
Category : BUSINESS & ECONOMICS
Languages : en
Pages : 92
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Book Description
The number of uninsured individuals and the rising cost of health insurance have been long-standing issues. The Patient Protection and Affordable Care Act (PPACA) mandated that most individuals have health insurance that provides minimum essential coverage or pay a tax penalty. To make health insurance more affordable and expand access, PPACA created the advance premium tax credit (APTC) to subsidize the cost of exchange plans' premiums for those eligible. This book examines what is known about the effects of the APTC and the extent to which affordable health benefits plans are available and individuals are able to maintain minimum essential coverage. Furthermore, new federal tax credits, authorized under the PPCA, first became available in 2014 to help certain individuals pay for health insurance. The tax credits apply toward premiums for private health plans offered through exchanges (also referred to as health insurance marketplaces). This book provides examples of hypothetical individuals and families that qualify for the premium credits and describes the eligibility criteria applicable to the premium tax credits and cost-sharing subsidies, and the calculation method for the credit and subsidy amounts. It also highlights selected issues addressed in the final regulation and guidance on premium credits and indicates the status of implementation, where relevant data is available.
Author: Linda J. Blumberg
Publisher:
ISBN:
Category :
Languages : en
Pages : 5
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Book Description
Under the ACA, approximately 23.2 million people will be eligible for financial assistance through the nongroup marketplaces in 2016. Of those 23.2 million, almost 60 percent are eligible for both tax credits to lower the cost of their health insurance premiums and CSRs to lower their direct out-of-pocket payments for medical services. Those eligible for both types of assistance are heavily concentrated in the South, almost half are single adults without children, and the majority are White. They differ from those eligible for premium tax credits alone in that they have lower income, tend to be younger, and more frequently report being in fair or poor health. In addition, if enrolled in the most comprehensive coverage for which they are eligible for assistance, they tend to incur somewhat higher health expenditures, consistent with their worse health status and their lower cost-sharing responsibilities. CSRs can play an important role in ensuring affordable access to care when needed, and comparing the characteristics of those eligible to receive them with those actually enrolling will allow us to identify individuals not being effectively reached through state, federal, and private outreach and enrollment efforts.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161
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Book Description
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Author: United States. Congressional Budget Office
Publisher:
ISBN:
Category : Competition
Languages : en
Pages : 72
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Book Description
Author: Susan Bennett
Publisher:
ISBN: 9781634846035
Category : Business & Economics
Languages : en
Pages : 111
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Book Description
Since 2014, the Patient Protection and Affordable Care Act (PPACA) has required most individuals to maintain health insurance coverage or potentially to pay a penalty for noncompliance. Specifically, most individuals are required to maintain minimum essential coverage for themselves and their dependents. Minimum essential coverage is a term defined in the ACA and its implementing regulations and includes most private and public coverage (e.g., employer-sponsored coverage, individual coverage, Medicare, and Medicaid, among others). Some individuals are exempt from the mandate and the penalty, and others may receive financial assistance to help them pay for the cost of health insurance coverage and the costs associated with using health care services. This book describes the individual mandate as established under the Patient Protection and Affordable Care Act. It also discusses the ACA reporting requirements designed, in part, to assist individuals in providing evidence of having met the mandate; describes the eligibility criteria applicable to the premium tax credits and cost-sharing subsidies, and the calculation method for the credit and subsidy amounts; highlights selected issues addressed in the final regulation and guidance on premium credits and indicates the status of implementation, where relevant data is available; examines IRS's implementation of these PPACA requirements; and IRS efforts to collaborate with key external stakeholders.
Author: Jesse Hinde
Publisher:
ISBN:
Category :
Languages : en
Pages : 62
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Book Description
The Patient Protection and Affordable Care Act (ACA) introduced several new policies in 2014, including an individual mandate, expanded Medicaid eligibility, and subsidized private coverage. Private subsidies include advance premium tax credits (APTCs) and cost-sharing reductions (CSRs). Individuals gain eligibility for APTCs and CSRs at 100% (138% in Medicaid expansion states) of the Federal Poverty Level (FPL), lose eligibility for CSRs at 250% FPL, and lose eligibility for the APTCs at 400% FPL. Using the Current Population Survey (CPS) and a regression discontinuity design, this study exploits the exogenous differences in subsidy eligibility in 2014 at three cutoffs to identify the separate and combined effects of the APTCs and CSRs on private insurance coverage. I estimate a 4.8 to 5.4 percentage point increase in private insurance coverage just above 138% FPL in Medicaid expansion states and a smaller effect above 100% FPL in non-expansion states attributable to the combined incentives. I calculate a demand elasticity for health insurance of -0.65 to -0.58, which is higher than most estimates in the literature, suggesting low-income individuals may be relatively more price responsive. There is no evidence of an effect on private health insurance at 250% FPL, attributable solely to the CSRs, and suggestive effects at 400% FPL, attributable to only the APTCs. Coverage increases do not appear to be driven by adverse selection, and there is no evidence of crowding-out or income manipulation around the cutoffs. APTC and CSR levels would need to be raised at higher incomes to induce more participation.
Author: Bernadette Fernandez
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 6
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Book Description
Author: Elliot Carpenter
Publisher: Nova Snova
ISBN: 9781536173741
Category :
Languages : en
Pages : 254
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Book Description
Since 2014, millions of individuals have purchased coverage through the health insurance exchanges established under Patient Protection and Affordable Care Act (PPACA). PPACA altered the individual health insurance market by setting federal standards for coverage and subsidizing exchange coverage for certain low-income individuals. In the first 5 years of exchanges, issuers have moved in and out of the market and increased premiums, but little is known about issuers' claims costs or the factors driving their business decisions. Chapter 1 examines (1) claims costs of issuers participating in exchanges, and (2) factors driving selected issuers' changes in exchange participation, premiums, and plan design. GAO reviewed data from nine issuers participating in five states, which were selected to represent a range in size, tax status, and exchange participation. During open enrollment, eligible returning consumers may re-enroll in their existing health insurance exchange plan or choose a different plan. Those who do not actively enroll in a plan may be automatically re-enrolled into a plan. Chapter 2 examines 1) the extent to which plans identified as benchmark plans remained the same plans from year to year, and how premiums for benchmark plans changed; 2) the proportion of exchange consumers who were automatically re-enrolled into the same or similar plans, and how these proportions compared to those for consumers who actively re-enrolled, and 3) the extent to which consumers' financial responsibility for premiums changed for those who were automatically re-enrolled compared to those who actively re-enrolled. Chapter 3 discussed the amendments to title XIX of the Social Security Act to ensure health insurance coverage continuity for former foster youth. Certain individuals without access to subsidized health insurance coverage may be eligible for premium tax credits, as established under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). The dollar amount of the premium credit varies from individual to individual, based on a formula specified in statute. Individuals who are eligible for the premium credit, however, generally are still required to contribute some amount toward the purchase of health insurance as described in chapter 4. During the summer of 2018, the Trump Administration issued final rules governing coverage offered through association health plans (AHPs) and short-term, limited-duration insurance. Chapter 5 describes how the Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) analyzed the new rules and determined how those rules would affect the agencies' projections of the number of people who obtain health insurance and the costs of federal subsidies for that coverage.
Author: Bernadette Fernandez
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 35
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Book Description
This report describes who will be eligible for the premium tax credits and cost-sharing subsidies, and how the credit and subsidy amounts will be calculated. It also highlights selected issues addressed in the final regulation on premium credits. The Appendix provides analysis of the concept of "affordability" as applicable to the premium credits.
