#ACA2 is desperately needed for the next few years REGARDLESS of whether we eventually move to MFA, Med4Am or some other universal coverage program.
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यह थ्रेड दिखाएं
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ACA2 could be fully implemented pretty much immediately, possibly even retroactively for some provisions. MFA or even Med4Am (which I support) will take several years to ramp up, so at least some ACA2 provisions would still be needed in the meantime.
यह थ्रेड दिखाएं -
As for
@LaurenUnderwood’s bill itself, here’s how much it would lower net ACA premiums:http://acasignups.net/19/04/11/how-much-would-house-aca-20-bill-cut-down-your-premiums …यह थ्रेड दिखाएं -
This table shows the *current* ACA subsidy formula: If you earn between 100-400% of the Federal Poverty Line ($12.5K - $50K if you're single, $25K - $100K for a family of 4), you only have to pay a maximum of the listed percent of income in premiums for a Silver ACA plan.pic.twitter.com/96yr9tP2MO
यह थ्रेड दिखाएं -
As you can see, right now, if you're single and earn, say, $25,000/year (200% FPL), you only have to pay 6.54% of that in premiums for a Silver plan ($136/month). If you earn $40,000 (320% FPL), you only have to pay 9.86% ($329/mo) for the Silver plan.
यह थ्रेड दिखाएं -
There are two problems with the current formula: First, the subsidies simply aren't generous enough for many. Secondly, if you earn more than 400% FPL ($50K if you're single, $100K for a family of 4), you get NO help AT ALL. Zilch.
@LaurenUnderwood's bill solves both issues.यह थ्रेड दिखाएं -
Here's the *new* ACA subsidy formula under
#HR1868. It shaves down the max % of income sliding scale (from 2 - 9.8% down to 0 - 8.5%), but it also *removes the 400% FPL eligibility cut-off* altogether, so a Silver ACA plan will never cost more than 8.5% of income no matter what.pic.twitter.com/p6H3lW0S1L
यह थ्रेड दिखाएं -
What does this mean in the real world? The following graphs are based on average national premiums for 2019 Silver ACA plans for a single adult at 4 different ages (30, 40, 50 & 60 years old). ACTUAL impact will vary WIDELY depending on your age, state, income and household size.
यह थ्रेड दिखाएं -
First, let's look at a single 30-year old. In their case, the avg. Silver premium is around $376/mo in 2019, so removing the 400% FPL cap wouldn't do much for them...but those earning 100 - 450% FPL would still see a savings of up to around $1,100/year.pic.twitter.com/TnqpSrWxSe
यह थ्रेड दिखाएं -
Next, the single 40-year old. From 100-400% FPL, they'd again save up to $1,100/year...but those earning between 400-500% FPL ($50K - $62K) would also save up to $800 or so compared to today.pic.twitter.com/VgQiQa6U72
यह थ्रेड दिखाएं -
How about at 50 years old? See that sharp spike at the 400% FPL line? That's called the "Subsidy Cliff". Right now a single 50-year old earning $49,960 receives $2,178 in financial assistance...but if they earn $49,961 (just $1 more!) they receive NOTHING...zilch.pic.twitter.com/UM8vKy9Zq7
यह थ्रेड दिखाएं -
THIS is the biggest reason why many middle-income Americans have dropped ACA policies in favor of
#ShortAssPlans and other types of "junk" insurance: If you're just a little over that 400% FPL line, ACA plans can eat up to 14% or more of your income.#HR1868 limits that to 8.5%.यह थ्रेड दिखाएं -
Under
#HR1868, a single 50-year old earning $50K - $87K would see their annual premiums reduced by as much as $237/month or over $2,800/year vs. what they have to pay today, while those earning 100-400% FPL would still save up to $1,100 vs current subsidies.यह थ्रेड दिखाएं -
FINALLY, what about a single 60-year old? My guess is there's very few 60-year olds who earn more than $50K/yr ($68K for a couple) on ACA-compliant individual market policies, and you're about to see why that is. WARNING: Sit down before looking at this graph.
यह थ्रेड दिखाएं -
Holy smokes. The average Silver premium for a single 60-year old in 2019 is $898/month, or nearly $11,000/year. Right now, if they earn $49,960, they'd qualify for an average of around $5,800/year in financial assistance...but if they earn just $1 more, that drops to nothing.pic.twitter.com/pop9BoLrye
यह थ्रेड दिखाएं -
Under
@LaurenUnderwood's#HR1868, again, NO ONE would have to pay more than 8.5% of their income for a benchmark Silver#ACA exchange plan. The 60-year old earning $50,000/year would go from paying over 21% of their income ($898/mo) to just 8.5% ($354/mo).यह थ्रेड दिखाएं -
The best part is that the actual net cost of this wouldn't be nearly as much as you might think. Estimates seem to range from $6B - $18B/year depending on the overall increase in enrollment (at least a few million more people) and what the demographic mix of those folks is.
यह थ्रेड दिखाएं -
While that's still a lot of money, consider that Donald Trump's CSR cut-off in 2017, which he THOUGHT would SAVE around $10-$12 billion/year, is ironically actually COSTING the federal government nearly $21 billion MORE per year.http://acasignups.net/19/03/03/dear-house-dems-csr-shoe-other-foot-now-negotiate-accordingly …
यह थ्रेड दिखाएं -
Oh, and for anyone who thinks ACA subsidies are simply “throwing money at insurance carriers”, note that every year we give employers $280 billion to provide private insurance coverage to 160 million employees & their families. That’s around $1,750 apiece. https://www.taxpolicycenter.org/briefing-book/how-does-tax-exclusion-employer-sponsored-health-insurance-work …
यह थ्रेड दिखाएं -
The employers, meanwhile, typically cover around 70-80% of their employees premiums, or around $5,600/year.https://www.peoplekeep.com/blog/what-percent-of-health-insurance-is-paid-by-employers …
यह थ्रेड दिखाएं -
By contrast, ACA subsidies average $6,168 per person for those receiving subsidies today. That’s more than employer coverage, but not THAT much more.http://acasignups.net/19/04/05/finally-deep-dive-2019-open-enrollment-period-report …
यह थ्रेड दिखाएं -
As
@MakaniKeoni just noted, right now that only applies to those CURRENTLY receiving ACA subsidies. Divided across ALL ACA enrollees, it’s only $3,800 apiece...exactly why the#ACA2 bill is quite reasonable. Adding $1,800/ea would just bring them up to par with employer coverage.यह थ्रेड दिखाएं -
If you assume the
#ACA2 bill caused, say, 2 million more to enroll in exchange plans (from ~13 million to ~15 million), and increased average subsidies across ALL ACA Indy market enrollees from $3,800 apiece to, say, $4,500 apiece, that’d raise fed spending by $10.5 billion.यह थ्रेड दिखाएं
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