I had intended to get on with Japan posting for a change, but I would be remiss if I did not point out, to my various Obamacare readers, something of a speedbump the ACA is going to hit in the next few months. I call this:
SHIFTING SECOND LOWEST COST SILVER.
As regular readers know, the federal tax credits available in the Affordable Care Act are based on the price of the second-lowest-cost Silver Plan (SLS) in your regional Marketplace. The Affordable Care Act defines what is “affordable” to you, and then the difference is made up by the federal credit.
What happens when the second-lowest-cost Silver Plan changes? What happens if you picked the 2014 SLS and now there are even cheaper Silver Plans come next January? Does the federal credit get reduced down to whatever would be the number for you to buy the new SLS plan?
The Health Care Marketplace was designed to promote cost savings and competition. As a result, one of the cost savings the Congress wrote into the law is that it will only pay credits based on whatever SLS is.
In my case, SLS was $261 a month. Next year, I will be one year older, and so the federal credit would have been a larger number, because Highmark could charge me extra as a 49-year-old.
However, if a rival insurer comes into the Lancaster County area, and offers the SLS, and it’s $230, I have to make up the difference if I want to keep Highmark. This easily means another $31 out of pocket ($261 minus $230), plus whatever the age bump-up would be. Maybe another $20.
Would Highmark be so stupid as to let a rival firm come in and underbid like that? Probably not. Insurance companies are smart. What should happen is that Highmark offer a Silver Plan with a higher deductible to compete with whatever newcomer(s) shows. In that way, you can keep your same insurer, with a price within whatever you were paying in 2014, with the only difference being what the deductible will be when you use the plan.
“Shifting SLS” is going to cause a lot of grief in places where no one has thought it through. Here’s to hoping people give it some effort this autumn.