The Sullivan Law Office focuses on the fact that every application for social security benefits is different. Applicants should understand every necessary detail before they file an application and the Social Security Administration (SSA) determines eligibility. The Sullivan Law Office may provide valuable assistance during the long and sometimes stressful gathering of personal information and medical evidence involved in the application process.

In the early period of his administration, the President has threatened to stop cost-sharing reduction (CSR) payments to insurers under the Affordable Care Act (ACA). If he succeeds, this would cause federal marketplace subsidy costs and premiums to increase, causing more insurers to withdraw from the marketplace, thus increasing the number of uninsured in 2018, according to the Congressional Budget Office (CBO).

Under the Affordable Care Act, approximately 6 million low- and moderate-income people enrolled through the marketplaces are eligible for cost-sharing reduction payments (CSR), which reduce deductibles and other out-of-pocket costs.

Under the ACA, the federal government is required to reimburse insurers for the cost, which is estimated at $7 billion a year, give or take a few hundred million. To qualify for CSRs, an individual must have income up to 250 percent of the poverty line and enroll in a silver marketplace plan. The CSRs reduce people’s out-of-pocket costs by roughly $1,100 per person on average.

Under the ACA, insurers must provide CSRs to enrollees even if federal payments cease. In this case, enrollees entitled to CSRs could still access plans with lower deductibles and other cost sharing, provided that a marketplace plan is available in their location.

Because the ACA’s premium tax credits are tied to the premiums for silver plans, these credits would increase if CSR payments cease. However, research by the CBO indicates that people with too much income to qualify for the credits would have to purchase coverage outside the marketplaces or enroll in less generous bronze or more generous gold marketplace plans.

The CBO eventually expects a greater share of people between 200 and 400 percent of the federal poverty line to purchase marketplace coverage if the law changes, due to the larger premium credits, which would then over time reduce the number of uninsured people. A potentially devastating result.

The Sullivan Law Office may assist all applicants throughout all steps of the administrative process of determining disability and eligibility for appropriate, related benefits. If you have any questions or concerns about any kind of disability case, including Social Security Disability, long-term disability, short-term disability, state retirement and workers’ compensation, call the Sullivan Law Office today! Call 888-587-0228 or visit us online.Cost Sharing Reduction Payments May Be Affected By New Federal Policy