Exchange Subsidies

June 1, 2016
Posted in ACA 101
June 1, 2016 LI Advantage

Exchange Subsidies

Section 1402 of the ACA allows cost-sharing reductions to certain people who obtain health insurance through the government exchange.  People that qualify will be reimbursed by the government for the cost-sharing reductions given to them.  The United States District Court for the District of Columbia ruled that Congress had not appropriated federal money for those reimbursements and it would be unconstitutional for those reimbursements to continue without a Congressional appropriation.  The result of this opinion has yet to be seen but it should not have any major effect on employers that sponsor group health coverage.  Individuals in this country must have health insurance.  If they work for an employer that is required to provide health insurance but doesn’t or the health insurance provided doesn’t meet ACA requirements, individuals can go to the exchange to get health coverage and possibly receive a subsidy.  This is what would trigger a penalty for the employer for not offering coverage or not offering the appropriate coverage.  The court opinion mentioned above will not effect this rule at all.

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