Discover and read the best of Twitter Threads about #silverloading
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🎉 #HappyNewYear! 2023 #ACA Open Enrollment is still ongoing in 49 states + DC! Here's 13 important things to remember before you #GetCovered: #xp
acasignups.net/23/01/01/2023-…
acasignups.net/23/01/01/2023-…
1. DON'T MISS THE DEADLINE!
The final #ACA Open Enrollment deadline is Jan. 15th in most states, for coverage starting Feb. 1st (in a few states it's as late as Jan. 31st.) #xp
The final #ACA Open Enrollment deadline is Jan. 15th in most states, for coverage starting Feb. 1st (in a few states it's as late as Jan. 31st.) #xp
Here's a table laying out the deadlines for each state. Note that some of these may be extended at the last minute...but don't count on that! #GetCovered sooner rather than later if at all possible! #xp 
🚨🚨🚨 The deadline is TONIGHT to enroll in #ACA healthcare coverage starting January 1st for most people in most states! Here's 13 important things to remember before you #GetCovered: #xp
acasignups.net/22/12/15/deadl…
acasignups.net/22/12/15/deadl…
1. DON'T MISS THE DEADLINE!
While the final #ACA Open Enrollment deadline isn't until January 15th in most states, if you want your coverage to start on January 1st, you have to enroll by MIDNIGHT TONIGHT.
In Idaho, today is the *final* deadline for 2023 coverage! #xp
While the final #ACA Open Enrollment deadline isn't until January 15th in most states, if you want your coverage to start on January 1st, you have to enroll by MIDNIGHT TONIGHT.
In Idaho, today is the *final* deadline for 2023 coverage! #xp
Here's a table laying out the deadlines for each state. Note that some of these may be extended at the last minute...but don't count on that! #GetCovered sooner rather than later if possible. #xp
📣📣📣 Annnnd we're off! The 2023 #ACA Open Enrollment Period has officially launched!
Here's 1️⃣3️⃣ important things to remember before. you #GetCovered:
acasignups.net/22/11/01/its-t…
Here's 1️⃣3️⃣ important things to remember before. you #GetCovered:
acasignups.net/22/11/01/its-t…
1. DON'T MISS THE DEADLINE!
While the final #ACA Open Enrollment deadline isn't until January 15th in most states, if you want your coverage to start on January 1st, you have to enroll earlier. Plus, Idaho's *final* deadline is in December.
While the final #ACA Open Enrollment deadline isn't until January 15th in most states, if you want your coverage to start on January 1st, you have to enroll earlier. Plus, Idaho's *final* deadline is in December.
Here's a table laying out the deadlines for every state. Note that some of these may be extended closer to the listed date...but don't count on that! #GetCovered sooner rather than later if possible.
The Washington Post is reporting that "Obamacare premiums are rising 4%" based on @KFF's estimate that *benchmark Silver premiums* are increasing by around 4% in 2023 vs. 2022. 1/ washingtonpost.com/politics/2022/…
That's an important distinction, as *overall* #ACA premiums are increasing by a bit more than that (around 6.2% across 32 states + DC): 2/ acasignups.net/22/10/26/updat…
However, the reality is that for the vast majority of #ACA enrollees, premiums won't be going up by either 4% or 6.2% thanks to the premium tax credits (aka financial subsidies) provided for by the #ACA which are dramatically enhanced by the #InflationReductionAct. 3/
(sigh) Over 7,500 people have "liked" her first tweet and over 1,200 have shared her misinformation. Worse yet, she's apparently an MD.
It's time once again for...The Three-Legged Stool®!
It's time once again for...The Three-Legged Stool®!
I can't believe I have to explain this over 10 years later, but under the Patient Protection & Affordable Care Act (the #ACA), INSURANCE CARRIERS CAN'T CHARGE HIGHER PREMIUMS TO PEOPLE BASED ON THEIR MEDICAL OR HEALTH CONDITIONS.
Here's how the #ACA's "3-legged stool" was designed (it's gone through a few changes over the years, most notably the federal individual mandate penalty being cut off & replaced with the World's Most Expensive Shim®):
📣🎉 AND WE'RE OFF!
My official 2022 #ACA Open Enrollment Guide: Here's the most important stuff to remember when you go to #GetCovered!
acasignups.net/21/11/03/and-w…
My official 2022 #ACA Open Enrollment Guide: Here's the most important stuff to remember when you go to #GetCovered!
acasignups.net/21/11/03/and-w…
1. MOST WILL HAVE MORE TIME BUT YOU STILL SHOULDN'T DELAY!
The final deadline has been extended by a full month in most states, but in order to have your COVERAGE START IN JANUARY you should still *ENROLL* BY DECEMBER 15th!
The final deadline has been extended by a full month in most states, but in order to have your COVERAGE START IN JANUARY you should still *ENROLL* BY DECEMBER 15th!
Here's the official enrollment deadlines for every state + DC. (Note: A few of these may change):
📣 THE 2022 #ACA OPEN ENROLLMENT PERIOD STARTS ON MONDAY.
Once again, the #ACA can be best described as a #3LeggedStool:
1. Insurer Responsibilities
2. Government Responsibilities
3. Enrollee Responsibilities
Let's review, shall we?
Once again, the #ACA can be best described as a #3LeggedStool:
1. Insurer Responsibilities
2. Government Responsibilities
3. Enrollee Responsibilities
Let's review, shall we?
1st Leg: INSURER RESPONSIBILITIES:
--Guaranteed Issue
--Community Rating
--Essential Health Benefits
--Minimum Actuarial Value
--No Annual/Lifetime Limits
--Maximum Out of Pocket Costs
--Free Preventative Services
--Can Stay on Parents Plan until Age 26
--Guaranteed Issue
--Community Rating
--Essential Health Benefits
--Minimum Actuarial Value
--No Annual/Lifetime Limits
--Maximum Out of Pocket Costs
--Free Preventative Services
--Can Stay on Parents Plan until Age 26
2nd Leg: ENROLLEE RESPONSIBILITIES:
--Limited-Time Open Enrollment Period
--Shared Responsibility Penalty*
*(no longer applies in 46 states...replaced by the World's Most Expensive Shim®)
--Limited-Time Open Enrollment Period
--Shared Responsibility Penalty*
*(no longer applies in 46 states...replaced by the World's Most Expensive Shim®)
This is a long, wonky post, but it also includes the simplest explanation I could give of how #SilverLoading works and why a lot of people were eligible for $0 premium Bronze or *Gold* plans even before the #AmRescuePlan expanded them further.
acasignups.net/21/03/29/old-l…
acasignups.net/21/03/29/old-l…
In short: Here's some sample 2017 Bronze, Silver & Gold premium & enrollment data. Let's say 2018 medical trend went up 5%. Meanwhile, let's say 1/2 the enrollees received CSR help averaging $2,400 apiece.
That's $120M in CSR reimbursements owed to the carriers from the feds.
That's $120M in CSR reimbursements owed to the carriers from the feds.
In late 2017, Donald Trump cuts off CSR reimbursements, figuring this will cause millions of low-income enrollees to lose their subsidies *or* for all the carriers to drop out of the ACA market (causing it to "blow up" and "collapse"), or both, to avoid eating a $120M loss.
Short version: The expanded subsidies in the #AmRescuePlan are fantastic, but are only for 2 yrs & only reduce premiums, not deductibles/co-pays. if @SenatorShaheen's #S499 becomes law, not only would that expansion be made *permanent*...
📣 NEW: PREPARE THYSELF: It may be in fits & starts, but #ACA2.0 *is* happening:
acasignups.net/21/03/15/prepa…
acasignups.net/21/03/15/prepa…
Four years ago I posted my (now sorely outdated) list of 20 changes to the #ACA I'd make If I Ran The Zoo (yes, I understand how awkward that title is at the moment): acasignups.net/18/02/12/updat…
In January, Sen. @MarkWarner introduced his Health Care Improvement Act which includes many of the same provisions: warner.senate.gov/public/index.c…
📣 UPDATED: 2021 #ACA Enrollment is (mostly) BACK! Here's *8* important things to remember:
acasignups.net/21/02/09/updat…
acasignups.net/21/02/09/updat…
1. DON'T MISS THE (new) DEADLINE!
Nearly every state is offering a *new* #COVID19 Enrollment Period this spring! Some have already started; most begin on February 15th. Here's a summary of the start/end dates as well as who's eligible to enroll via the new enrollment period: 2/
Nearly every state is offering a *new* #COVID19 Enrollment Period this spring! Some have already started; most begin on February 15th. Here's a summary of the start/end dates as well as who's eligible to enroll via the new enrollment period: 2/
2. BE CAREFUL TO AVOID JUNK PLANS!
Make sure you enroll in an #ACA-compliant policy by using an *official* ACA exchange website.
If you *do* use a 3rd-party site, make sure it's an *authorized* ACA enrollment partner which *only* sells ACA policies, like Health Sherpa. 3/
Make sure you enroll in an #ACA-compliant policy by using an *official* ACA exchange website.
If you *do* use a 3rd-party site, make sure it's an *authorized* ACA enrollment partner which *only* sells ACA policies, like Health Sherpa. 3/
🚨 UPDATE: The Public Comment period for the #NBPP2022 starts *TOMORROW* (12/04) and only runs 26 days (instead of 30) thru 12/30...including Christmas.
We need to flood 'em w/comments to stop Trump from trying to kill HCgov on his way out the door.
acasignups.net/20/12/02/updat…
We need to flood 'em w/comments to stop Trump from trying to kill HCgov on his way out the door.
acasignups.net/20/12/02/updat…
The short version is this: Every year CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP), which is basically a bunch of tweaks to administrative details for the upcoming ACA Open Enrollment Period. 2/
Some of these are standard, like slightly bumping up the Maximum Out of Pocket cap for the following year. Some are good ideas, like adding a Special Enrollment Period for people who enrolled off-exchange but then have an income drop qualifing them for on-exchange subsidies. 3/
📣💥 OH, YEAH: #ACA Open Enrollment starts TODAY!
Here's 7 important things to remember:
acasignups.net/20/11/01/oh-ye…
Here's 7 important things to remember:
acasignups.net/20/11/01/oh-ye…
1. DON'T MISS THE DEADLINE!
In most states you have until 12/15 to #GetCovered, but 9 states + DC have longer deadlines to sign up (though your coverage may start later).
In most states you have until 12/15 to #GetCovered, but 9 states + DC have longer deadlines to sign up (though your coverage may start later).
2. MAKE SURE YOU ENROLL IN AN ACA-COMPLIANT PLAN!
There's lots of scam sites out there, plus sites which are legal but still mix ACA plans w/junk plans. Stick to either the official ACA exchange sites *or* to authorized partner sites which *only* sell fully ACA-compliant plans.
There's lots of scam sites out there, plus sites which are legal but still mix ACA plans w/junk plans. Stick to either the official ACA exchange sites *or* to authorized partner sites which *only* sell fully ACA-compliant plans.
📣 OH, YEAH: #ACA Open Enrollment starts Sunday! Here's 7 important things to remember:
acasignups.net/20/10/30/oh-ye…
acasignups.net/20/10/30/oh-ye…
1. DON'T MISS THE DEADLINE!
In most states you have until 12/15 to #GetCovered, but 9 states + DC have longer deadlines to sign up (though your coverage may start later).
In most states you have until 12/15 to #GetCovered, but 9 states + DC have longer deadlines to sign up (though your coverage may start later).
2. MAKE SURE YOU ENROLL IN AN ACTUAL ACA PLAN!
There's lots of scam sites out there, plus sites which are legal but still mix ACA plans with junk plans. Stick to either the official ACA exchange sites *or* to authorized partner sites which *only* sell fully ACA-compliant plans.
There's lots of scam sites out there, plus sites which are legal but still mix ACA plans with junk plans. Stick to either the official ACA exchange sites *or* to authorized partner sites which *only* sell fully ACA-compliant plans.
Something tells me I need to read this pronto...
I actually already wrote an in-depth thing about @sarahkliff’s individual mandate story back in January: acasignups.net/20/01/15/was-i…
In addition to many other points I cover, it’s important to remember that the third leg of the stool may have been cut off, but it was also immediately replaced by the World’s Most Expensive Shim...in the form of ~$5 billion/year in additional subsidies to cover the rate hikes.
@HoarseWisperer If you’re interested, I’ll tell you the story of how Trump was so incompetent at sabotaging the ACA he accidentally improved it (sort of).
@HoarseWisperer Sorry, it’ll have to wait until tomorrow. I’ll start at this point, though, so check back here...
@HoarseWisperer Here’s a teaser: There was a court ruling about it today, though it didn’t get much attention.
📣 In light of both @thehowie & @pbump's comments: A couple of years back I crated a video explainer re. how the #ACA's 3-legged stool works and why covering pre-existing conditions w/out the rest of the ACA in place is a recipe for disaster. 1/
It's a bit out of date (it predates the mandate penalty actually being zeroed out by the GOP), but it's still a good overview:
Here's what the #ACA's 3-legged stool was originally supposed to look like. When people talk about "protections for coverage of pre-existing conditions", they're basically talking about the Blue Leg on the left:
You’ve got to be fucking kidding me.
According to @loujacobson of @PolitiFact, if a President promises NOT to do a thing, then TRIES to do a thing but fails because Congress shot it down, that means they "kept their promise." 2/
So if I promise NOT to commit murder, and once elected I *attempt* to commit murder but I'm stopped by the police before I can pull it off, I guess that means I get credit for "keeping my promise". 3/
📣 This morning the Trump Admin issued a press release crowing about #ACA premiums dropping 4% thanks to their supposedly brilliant management.
I need to clear up a few things about this. 1/
I need to clear up a few things about this. 1/
First of all, it’s important to note that the 4% drop refers specifically to *benchmark Silver plans* only, and only includes 39 states. It also only includes exchange-based enrollment. These factors limit it to < 40% of total #ACA-compliant individual market enrollment. 2/
When you include *all* metal levels for *all* states both on & off-exchange, the weighted avg is ⬆️ 0.1% instead of ⬇️ 4.0%.
Obviously that’s still far better than double-digit increases, but it’s important to be as comprehensive & accurate as possible.
acasignups.net/rate-changes/2…
Obviously that’s still far better than double-digit increases, but it’s important to be as comprehensive & accurate as possible.
acasignups.net/rate-changes/2…
1/n #ACA Premiums and landscape files are out so here are the first thoughts:
Headline: Gross Premiums down 4% YoY
@dylanlscott @leonardkl @sangerkatz @sarahkliff @bobjherman @caitlinnowens @rachanadixit
Headline: Gross Premiums down 4% YoY
@dylanlscott @leonardkl @sangerkatz @sarahkliff @bobjherman @caitlinnowens @rachanadixit
2/N Lots of things are happening.
The biggest one is that 2018 was so massively overpriced that 2020 (these rates) are still reflecting that problem. 2 different pricing scenarios get us to the same point with different stories
The biggest one is that 2018 was so massively overpriced that 2020 (these rates) are still reflecting that problem. 2 different pricing scenarios get us to the same point with different stories
3/N 2018 was a huge policy shock for pricing with massive uncertainty on #CSR leading to insurers either running from the market entirely, retrenching or jacking up rates
As soon as CSR Terminated (October 2017), #Silverloading differentially increased silver premiums by a lot
As soon as CSR Terminated (October 2017), #Silverloading differentially increased silver premiums by a lot
⚠️⚠️⚠️ ADVANCE WARNING: Long wonky MLR rebate thread ahead! All 50 states + DC!
One of the provisions of the #ACA is the “Medical Loss Ratio” provision, which requires health insurance carriers to spend a minimum of 80% or 85% of their premium revenue on actual healthcare/medical claims. It’s 80% for the Individual & Sm. Group markets, 85% for Lg. Group. 1/
Simple version: If an insurance carrier spends *less* than 80% (85%) on medical claims, weighted over a 3-year average, they have to *pay back* the excess to the policyholders.
So, if they bring in $100M in premiums & only pay out $75M in claims, they have to rebate $5M. 2/
So, if they bring in $100M in premiums & only pay out $75M in claims, they have to rebate $5M. 2/
🗣 THREAD: A Kinda, Sorta Deep Dive into the 2020 NBPP! acasignups.net/19/04/19/kinda…
The #NBPP2020 is a long, wonky document from CMS which basically lays out the rules for the 2020 #ACA Open Enrollment period. Most of it is basic stuff like setting the dates (Nov. 1 - Dec. 15th) and the like, but it also makes some tweaks to the subsidy formula and so forth. 1/
As you can imagine, some of these changes are pretty benign, but others will have big implications for #ACA enrollees in 2020. There's a total of 17 items on the list, a few of which I actually don't understand well enough to comment on, but let's take a look at the rest! 2/
⚠️ THREAD: When the dust settles on the 2019 Open Enrollment Period, total enrollments will likely be ~11.4M on exchange, plus perhaps 3M off-exchange. Of the 14.4M total, around 13M (90%) will actually pay their premiums. 1/
Of those 13M people, around 4.2 million will be unsubsidized & have to pay full price...and that full price will average around $49/month higher in 2019 than it would have been if Trump & the GOP hadn't repealed the individual mandate & opened the floodgates on #ShortAssPlans. 2/
This is the case even in states where 2019 premiums are *dropping* in 2019 (or staying flat)...they would have gone down *even more* without those changes. Many of the carriers have stated this specifically in rate filings, w/many including actuarial data to support it. 3/
THREAD: For those who still don’t understand how important the #ACA #TexasFoldEm case is (along #StopKavanaugh), here’s a simple timeline of the ACA’s 3-Legged Stool:
1/ Here’s how the #ACA’s 3-Legged Stool was *supposed* to work when the law was passed. The blue leg includes the patient protections. The red leg is the part everyone hated but which served an important purpose. The green leg is the financial help for people to pay for it.
2/ This is what it ACTUALLY ended up looking like: There were two main problems. The financial assistance was cut off at 400% FPL income (& wasn’t generous enough), and the mandate penalty wasn’t strong enough to be fully effective. Both were EASILY fixable.
