Source: https://taxcredits.healthreformquotes.com/individual-mandate/30-penalty-not-prior-coverage-donald-care/
Timestamp: 2018-12-11 11:13:12
Document Index: 637750152

Matched Legal Cases: ['§133', '§133', '§133', '§133', '§ 300', '§ 300']

z30% Penalty for not having prior coverage - Donald Care AHCA §133 Historical - Tax Credits & Subsidies - Info & FAQ's z30% Penalty for not having prior coverage - Donald Care AHCA §133 Historical - Tax Credits & Subsidies - Info & FAQ's
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HR 1628 Congress.Gov AHCA of 2017
Section 133 – 30% Penalty – Continous Coverage Encouragement
This page is Historical and Reference ONLY
AHCA §133 CONTINUOUS HEALTH INSURANCE COVERAGE INCENTIVE.
–let insurers charge individuals who buy insurance after letting their coverage lapse – so be VERY careful about paying your premiums on time!, a 30% premium penalty for one year, to encourage people to maintain continuous coverage. Section 133 Rev 3.6.2017 page 61
The substitute mechanism employed in section 133 of the AHCA requires insurers to charge purchasers a 30% “penalty” if they obtain coverage in a given year without having had coverage in the preceding year. The idea is that, in order to avoid those higher rates, individuals will be incentivized to purchase health insurance even in those years when they feel the premiums are high relative to their expected costs. But under the AHCA you don’t generally need coverage in 2017 in order to get coverage in 2018. At least so long as you purchase your policy during the (shortened) open enrollment period at the end of 2017, there’s no continuous coverage requirement in 2018. It starts in 2019.
AHCA piggybacks on earlier statutes (42 U.S.C. § 300gg-3 and 42 U.S.C. § 300gg-91, for those scoring at home – our webpage) and defines creditable coverage to include “health insurance coverage,” which essentially means anything that covers health expenses, no matter how minimally. Forbes 3.6.2017 Continous Coverage needs a redraft
That penalty could discourage many people from getting new coverage if they lose their plan because of a job loss or other change. That could increase the number of uninsured Americans. Los Angeles Times 3.8.2017
The AHCA bans discrimination against those with preexisting conditions — but charges more to people who have a break in coverage
If a worker goes straight from insurance at work to her own policy, her insurer has to charge her a standard rate — it can’t take the cost of her condition into account.
But if she had a lapse in coverage longer than 63 days — perhaps she couldn’t afford a new plan between jobs — and went to the individual market later, insurers could charge her a 30 percent premium surcharge. She would need to pay that higher premium for a full year before returning to the standard rate.
A Congressional aide clarified that this surcharge would be the same for both healthy and sick people; insurers could not use it to turn away people they expect to have significantly higher medical costs.
This might end up having unintended consequences, because only the people who really need insurance — and who have high medical costs — may want to pay the surcharge. Healthy people might be more comfortable staying out of the individual market for longer, perhaps until they get a job that offers coverage. That could drive up premiums for everybody.
This is a less harsh penalty than the one Price suggested in his 2015 Empowering Patients First Act. In that bill, he would have allowed insurers to charge people like this 150 percent of the standard premium for 18 months.
The leaked draft does have a safety net for people who can’t afford to buy this more-expensive coverage. It would invest $100 billion over 10 years into a Patient and State Stability Fund. States could use this money to bump up the size of the tax credits in the individual market (more on that in a minute), build high-risk pools for those with exceptionally costly medical conditions, or send money to insurers who get stuck with especially costly patients (people who have claims higher than $50,000 in a single year). Vox 3.6.2017
IMHO this is like the penalty in Part D Rx Medicare
More on American Health Care Act AHCA – Donald Care
“(1) IN GENERAL.—Notwithstanding section 2701, subject to the succeeding provisions of this section, a health insurance issuer offering health insurance coverage in the individual or small group market shall, in the case of an individual who is an applicable policyholder of such coverage with respect to an enforcement period applicable to enrollments for a plan year beginning with plan year 2019 (or, in the case of enrollments during a special enrollment period, beginning with plan year 2018), increase the monthly premium rate otherwise applicable to such individual for such coverage during each month of such period, by an amount determined under paragraph (2).
“(B) cannot demonstrate (through presentation of certifications described in section 2704(e) or in such other manner as may be specified in regulations, such as a return or statement made under section 6055(d) or 36C of the Internal Revenue Code of 1986), during the look-back period that is with respect to such enforcement period, there was not a period of at least 63 continuous days during which the individual did not have creditable coverage (as defined in paragraph (1) of section 2704(c) and credited in accordance with paragraphs (2) and (3) of such section); and
“(C) in the case of an individual who had been enrolled under dependent coverage under a group health plan or health insurance coverage by reason of section 2714 and such dependent coverage of such individual ceased because of the age of such individual, is not enrolling during the first open enrollment period (special enrollment – loss of MEC?) following the date on which such coverage so ceased.