‘Free’ insurance for many in Pa. a result of slashed subsidy
President Donald Trump speaks to the 2017 Value Voters Summit, Friday, Oct. 13, 2017, in Washington. One perhaps surprising result of the president cutting the cost sharing reduction is many Pennsylvanians qualify for zero-premium insurance. (AP Photo/Evan Vucci)
Affordable Care Act open enrollment is officially underway, and premiums are up.
However, many people may qualify for plans that have no premiums at all.
The perhaps surprising circumstance came after President Donald Trump cut the cost sharing reduction for 2018, a more-than $7 billion federal subsidy that helps lower-income ACA users.
State Department of Insurance commissioner Jessica Altman says the slashed funds led insurance companies to ratchet up premiums as they prepared to eat more costs. In Pennsylvania, such premiums increased an average of 31 percent.
Here’s where things take another twist. Because insurers jacked up premiums, more ACA consumers qualify for another subsidy called the premium tax credit.
In many cases, Altman says, those subsidies cover their entire premiums.
A zero dollar premium doesn’t mean the care is “free,” Altman says. The zero-premium plans likely will come with high deductibles. “It can be very tempting to go for the lowest-cost premium, only to find that you have a very high deductible,” she adds.
While the zero-premium insurance may seem like a boon for lower-income people, cutting the cost sharing reduction costs the federal government a lot more money in the long run, according to the Congressional Budget Office.
The CBO predicts that the federal deficit will increase by $194 billion over the next 10 years unless the cost sharing reduction is resumed.
Open enrollment ends Dec. 15.
Brett Sholtis was a health reporter for WITF/Transforming Health until early 2023. Sholtis is the 2021-2022 Reveal Benjamin von Sternenfels Rosenthal Grantee for Mental Health Investigative Journalism with the Rosalynn Carter Fellowships for Mental Health Journalism. His award-winning work on problem areas in mental health policy and policing helped to get a woman moved from a county jail to a psychiatric facility. Sholtis is a University of Pittsburgh graduate and a Pennsylvania Army National Guard Kosovo campaign veteran.