Government Shut Down and Affordable Care Act Tax Credits

We've been receiving a lot of emails and calls concerning the ACA tax credit debate. As many of you know, there is an ongoing argument concerning "Enhanced Tax Credits" for the Affordable Care Act plans. Here are the bullet points to know:

• The ACA (Affordable Care Act) increased individual health insurance premiums by adding additional coverages and taxes to health insurance plans.
• A person may qualify for "Advance Tax Credits" to lower their individual ACA health insurance premiums, bringing down their premiums dramatically.
• During COVID, "Enhanced Tax Credits" were created. This not only increased the tax credits, but also removed the income "threshold" in which a household would lose all tax credits if their income was above that "threshold."
• The Enhanced Tax Credits are set to expire at the end of 2025. The extension of these tax credits is one of the items Democrats and Republicans are arguing over.
• If the Enhanced Tax Credits go away, the standard ACA tax credits will still be in affect. However, net premiums will certainly increase with less tax credits. Those households with income of the "threshold" will pay a much higher premium, as they will lose all tax credits.

We are recommending our customers update their application at the beginning of November. To do so, please reply to this email requesting we update your account. We will then reply with several questions to make sure we have the most accurate information.

Once the update is completed, we will email the updated premiums along with other options.

Affordable Care Act Changes Paused By Maryland Court

What happened: The federal district court in Maryland stayed (paused) the effective date of some, but not all, provisions in the recent CMS Program Integrity Rule.

What is a stay: A stay is a judicial action that temporarily pauses a regulation's effective date, giving a court more time to review the case. In this instance, the stay is pausing certain provisions in the Program Integrity Rule from taking effect.

What provisions were stayed (paused) from taking effect:

• Creating annual income Data Matching Issues (DMIs) when applicants attest to income above 100% FPL, but trusted data sources show income below 100% FPL
• Implementing a $5 fee for FFM members who auto-renew into a $0 plan and do not verify APTC eligibility
• Reverting the Failure to File and Reconcile (FTR) period to 1 year → the FTR period will remain 2 years
• Requiring Federal Exchanges to conduct Special Enrollment Period (SEP) verifications for at least 75% of new enrollments