COVID-19 stimulus bills, your clients, and their ACA coverage

By HealthSherpa

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In the last month, 3 stimulus packages have been passed by Congress and the Trump administration. These bills are meant to help health systems, economic sectors, and the American people battle and recover from the COVID-19 pandemic. 

To save you time, here is the key information to know for your clients from these bills. 

What legislation has the federal government passed in response to COVID-19?

There have been three stimulus packages, commonly referred to as phases, passed since the beginning of March: the Coronavirus Preparedness and Response Supplemental Appropriations Act (Stimulus Phase I), the Families First Coronavirus Response Act (Stimulus Phase II), and the Coronavirus Aid, Relief, and Economic Security Act (the CARES act, Stimulus Phase III).  

• Stimulus Phase I provided a total of $8.3 billion to a select group of federal agencies (e.g. CDC, FDA, NIH), to make coronavirus tests available, and loan subsidies for small businesses.
• Stimulus Phase II provided paid sick leave, tax credits, increased funding for Medicaid, expanded unemployment benefits and food assistance, and free COVID-19 testing. 
• Stimulus Phase III provided a total of $2 trillion in direct aid to impacted industries, small businesses, American families, and health systems.

It’s likely that Americans will see other relief measures passed in the coming weeks. The white house and both democrats and republicans in congress are actively working on other ways to help American citizens and businesses through this pandemic.

Will COVID-19 stimulus bills impact my clients?

Phase II has implications on the coverage your clients can expect for COVID-19 testing with their Affordable Care Act (ACA) compliant health insurance.

• The CARES act requires all group health plans and individual health insurance coverage to waive all cost sharing for testing and associated visits related to the diagnosis of the COVID-19 during the emergency period. This includes all Affordable Care Act health insurance plans on the Marketplace.
  
  • However, this doesn’t cover treatment that follows a positive test, and won’t cover labs that may be administered at the time of testing that aren’t related to COVID-19. 
  • Some insurers have publicly announced that they will be waiving additional cost sharing for treatment. America’s Health Insurance Plans is maintaining this list of how health insurers are responding to COVID-19.

Phase III has implications on your client’s eligibility for cost sharing reductions (CSRs).

• The bill includes two big relief efforts:
  
  • An additional $600/week for 4 months through the newly created Pandemic Unemployment Assistance program. This will need to be added into the client’s projected annual income for the purposes of determining APTC, but must be excluded when calculating Medicaid eligibility.
  • A rebate of $1,200 plus $500 per dependent for individuals making less than $75k and married couples making less than $150k. So a family of 4 made up of 2 parents and 2 kids could expect to get a check for $3,400. The treasury will use 2018 and 2019 tax filings to distribute these funds.
• The Pandemic Unemployment Assistance program will also help people that traditionally aren’t eligible for unemployment benefits, including self-employed individuals and independent contractors (gig workers). 

HealthSherpa is here for you, so you can be there for your clients

Americans across the United States need the expertise of health insurance agents now more than ever. In the last two weeks of March alone, more than 10 million Americans filed for unemployment benefits due to the coronavirus pandemic. Many of these people are navigating buying their own health insurance for the first time. 

You can be there to help them understand their options and get quality coverage. 

If a client reaches out to you because they lost their employer-sponsored health insurance, they qualify for a Special Enrollment Period (SEP). They have a 60 day window of eligibility to sign up for a Marketplace plan. 

As an agent, you can help them through the enrollment process, and you can do that easily through your HealthSherpa account. Log in today.

New to HealthSherpa? Don’t worry — it’s easy to get started with a free HealthSherpa for Agents account. HealthSherpa is a certified partner of healthcare.gov, and we are able to help you enroll your clients directly on our site with Enhanced Direct Enrollment (EDE). Through a HealthSherpa account, you can enroll, track, and service your ACA clients year-round. Visit our HealthSherpa for Agents page today to learn more and sign up for an account.