THREAD: OK, here’s how (and how many) people will be impacted by the #CSR #ACASabotage 1/n:…
2/ First of all: If your income is under 400% FPL (~$48K for a single adult, ~$98K for a family of 4), you likely won’t be impacted at all.
3/ Your FULL PRICE rates will increase, if you buy through the #ACA exchange, your tax credits should rise to roughly match the increase…
4/ …so you likely won’t pay any more (and may possibly pay less) than this year. That’s around ~8M people. Where things get trickier…
5/ …are for UNSUBSIDIZED people in #ACA compliant plans, both on & off the exchange (around 6.5 million people). Here’s how they’ll fare:
6/ By my calculations, as of Nov. 1st, there should be ~1.5M unsubsidized enrollees on the #ACA exchanges and ~5.0M in OFF-exchange plans…
7/ Note that there’s also around ~2.1M people enrolled in Grandfathered or Transitional plans, but those are SEPARATE from all of this.
8/ Now, those ~6.5M unsubsidized enrollees will have 5 different paths depending on which state they live in:…
9/ IMPORTANT: This spreadsheet is a) rough estimates and b) a few more states could change categories over the next week.
10/ However, assuming it’s fairly accurate & no major changes going forward, here’s the breakout:
11/ Around 440K people live in “No Load” states, which assumed #CSR payments would continue. They shouldn’t have to pay the #CSR surcharge.
12/ However, these are also the most likely to change status next week (except ND which gave a flat *no*, and DC which is a special case).
13/ Next up: “Broad Load” states, which appear to be spreading #CSR cost across ALL plans, on & off exchange. Around 376K here…
14/ The bad news: These folks will face some CSR surcharge regardless of the plan they choose. Hoping a few of these states can switch to…
15/ …one of the remaining categories…which brings me to “Silver Load” states (the most common choice). Around 1.8M unsubsidized folks here..
16/ In these states, the full CSR load has been added to Silver plans *only*…both on & off exchange. This means that if you’re enrolled…
17/ …in a Bronze, Gold or Platinum plan either on or off-exchange, you won’t see the CSR surcharge at all. If you’re on a Silver plan…
18/ …and are subsidized, of course, your subsidies should rise to match; if you’re in an *unsubsidized* silver plan in these states…
19/ …then you’ll have a tough choice to make. However, Gold plans may actually be a better bargain since the price gap will be narrow.
20/ The *best* strategy by far is the next one: #SilverSwitcharoo, which 13 states have chosen. ~2.8M unsubsidized enrollees in these states
21/ #SilverSwitcharoo is the most beneficial, but also most confusing. Like “Silver Load” states, all CSR cost is dumped on Silver plans…
22/ …except unlike “Silver Load”, Switcharoo states ONLY add CSR to *on exchange* Silver plans. This concentrates the load even more…
23/ …but vast majority of on exchange Silver enrollees are subsidized, so it minimizes the number exposed. That’s Part 1…
24/ Part 2 is the “switch”: Unsubsidized Silver enrollees (both on/off exchange) then SWITCH to a *different* off-exchange ONLY Silver plan.
25/ Since this other Silver plan is off-exchange only, there’s no CSR surcharge, but it’s virtually the same as their existing Silver.
26/ Of course, they can also upgrade/downgrade to Gold or Silver if they wish. The point is that EVERYONE avoids the CSR hit (in theory).
27/ AFAICT, around 2.8M unsubsidized enrollees live in Switcharoo states; *in theory*, every one of them *should* be able to avoid CSR hit.
28/ Finally, there’s a handful of states which are “Mixed”…that is, each carriers is choosing different strategies from the other 4 options.
29/ In “Mixed” states, I haven’t the slightest clue what the unsubsidized rates/options are gonna look like. Could be really weird.
30/ Bottom Line: Yes, it’s gonna be confusing…but if you #SHOPAROUND, *most* people will do better or at least no worse than this year.
31/ So whatever you do, DON’T passively auto-renew; ACTIVELY #ShopAround, even if you THINK you aren’t eligible for a subsidy…
32/ …because for 2018, I suspect many more people WILL be eligible (even if their income is the same as 2017).

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More from @charles_gaba

Aug 27, 2018
⚠️ GRAPHICS-HEAVY THREAD: Next week, the #TexasFoldEm lawsuit brought by 20 Republican Attorneys General against the #ACA goes to court. The Trump Administration is refusing to defend against it even though it EVERY legal expert says it’s a pile of steaming garbage. 1/
2/ If the #TexasFoldEm plaintiffs succeed, federal protections for those w/#PreExistingConditions would be gone. Not just on the individual market…people w/EMPLOYER coverage would be at risk as well, especially since most people are out of a job at least once in their lives.
3/ Here’s a reminder of the idiotic “argument” the #TexasFoldEm plaintiffs are using:
1. SCOTUS ruled the #ACA mandate is only Constitutional because it’s a tax.
2. The GOP repealed the mandate tax.
3. Therefore, they get to repeal the rest of the #ACA as well.
Really. That’s it.
Read 67 tweets
Aug 21, 2018
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.
Read 13 tweets
Aug 13, 2018

Do you remember “Harry & Louise”?

Here’s a reminder. Watch both commercials, but especially the second one. There’s a LOT going on here:

2/ First of all, notice how in 1993, “community rating” (i.e., not being allowed to charge people more based on their health status) was considered a HORRIBLE thing.
3/ Cut to 2018: 8 yrs after the Affordable Care Act was signed into law, 89% of the public thinks it’s important NOT to charge people more for their health insurance based on their health status. EIGHTY-NINE PERCENT. This is the real legacy of the #ACA.…
Read 19 tweets
Aug 10, 2018
ATTENTION MICHIGAN RESIDENTS: I’m trying to track down the Twitter handles for the following 2018 Democratic nominees; please help if you can, thanks!

HD001: Tenisha Yancey
HD003: Wendell Byrd
HD004: Isaac Robinson
HD005: Cynthia A. Johnson
HD006: Tyrone Carter
HD012: Alex Garza
HD013: Frank Liberati
HD014: Cara Clemente
HD016: Kevin Coleman
HD022: John Chirkun
HD024: Laura Winn
HD025: Nate Shannon
HD028: Lori M. Stone
HD030: John P. Spica
HD031: William J. Sowerby
HD032: Paul Manley
HD036: Robert Murphy
HD045: Kyle Cooper
HD048: Sheryl Y. Kennedy
HD049: John D. Cherry
(yes, THAT John Cherry…he doesn’t seem to be on Twitter?)
HD050: Tim Sneller
HD051: David E. Lossing
HD054: Ronnie D. Peterson
HD056: Ernie Whiteside
HD057: Amber Pedersen
HD058: Tamara C. Barnes
HD059: Dennis B. Smith
HD063: Jennifer Aniano
Read 5 tweets
Aug 10, 2018
THREAD: Yeah, I have insomnia, so here’s some wonky info re. single payer, M4A and the Michigan Gubernatorial primary. 1/
2/ Now that the #MIGov primary is over, since the most contentious debate between El-Sayed and Whitmer (besides 'dark money') was about single-payer healthcare, let's get a few things straight:
3/ 1. "Single Payer" refers to any healthcare system where the gov’t is the payment source for healthcare providers (doctors/hospitals/drug cos/etc).
Read 44 tweets
Aug 8, 2018
How Much More Will #ACASabotage Cost Unsubsidized Enrollees in YOUR Congressional District???
1/ Last year, I posted state-by-state infographics which broke out the estimated number of Americans who would lose healthcare coverage if each of the various #ACA repeal bills form the GOP were to become law.
2/ At first I used my own estimates, but then @EmilyG_DC and her colleagues from the Center for American Progress (@amprog) stepped up and started compiling their own projections. Their methodology was different but our estimates were generally in the same range.
Read 67 tweets

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