We recently receive news of another possible workaround for the problem plagued healthcare.gov website. Last week I learned that the National Association of Health Underwriters (NAHU) has requested clarification from the IRS on the subject of subsidy eligibility for consumers who purchase a Qualified Health Plan (QHP) directly from an insurer. Specifically, it was asked if subsidy determination could be made at a later date, for example, at the time of 2014 tax filing. Currently, as the law stands, coverage must be purchased through the Federal Marketplace to be subsidy eligible. However, a change in this interpretation of the law could open the door for many more consumers to get enrolled, without the burden of applying through healthcare.gov. The downside, however, is that consumers would have to finance the entire unsubsidized cost of the premium up front. Considering the median household income in North Carolina is roughly $45,000 per year, this could present a financial challenge for many residents who are already struggling with high premiums. However, we view any additional enrollment options as a move in the right direction! See below for the full NAHU update on the subject of carrier direct policy subsidies:
Finally, NAHU is seeking clarification from the IRS on a subsidy issue, which if resolved could also facilitate enrollment more directly. We have requested immediate clarification if individuals who can afford to advance the premium on their own monthly but might also be subsidy eligible could by an exchange offered QHP directly from a carrier “off the marketplace” and with out getting a marketplace subsidy determination. We have asked if it would be permissible for those individuals to obtain a subsidy determination and advance premium credits later, when the marketplace is working better, or simply claim the credit on their 2014 taxes with an exchange-based determination. As soon as we get resolution to this issue, we will let the membership know.