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Trump administration offers two more ways to escape Obamacare's penalty

Americans now have two additional ways to get out of paying Obamacare's individual mandate penalty.The Trump a...

Posted: Apr 10, 2018 10:47 AM
Updated: Apr 10, 2018 10:47 AM

Americans now have two additional ways to get out of paying Obamacare's individual mandate penalty.

The Trump administration announced Monday that those who live in counties with no insurer or with only one choice will be able to apply for a hardship exemption from the mandate, which requires nearly all Americans to get health insurance or pay a penalty.

Every county currently has at least one insurer on its exchange, but about 26% of Obamacare enrollees -- living in slightly more than half of counties -- have only one option, according to the Kaiser Family Foundation.

Also, pro-life Americans who can only buy plans that cover abortion can receive an exemption.

The broadening of the exemptions won't matter after this year since Congress eliminated the individual mandate penalty starting in 2019. Until now, hardship exemptions were typically granted to those who were homeless, facing eviction, had filed for bankruptcy or were in other difficult situations. People could also apply for income-related exemptions if the only plans in their areas were too costly or they earned too little to file a tax return.

The Trump administration also took another step Monday to put its stamp on the Affordable Care Act by releasing new rules for 2019.

Since Congress failed to repeal and replace the health reform law, administration officials can only adjust Obamacare's regulations. Like its prior moves, the administration says the 2019 guidance focuses on lowering costs and increasing choices for consumers, states and insurers.

Obamacare supporters, however, argue that the changes will only further undermine the law and hurt the millions who depend on it.

"This rule reduces protections for people with pre-existing conditions, increases the cost of health coverage, and makes it harder for consumers to sign up for coverage," said Sam Berger, senior adviser at the Center for American Progress, a left-leaning group.

One of the more significant changes provides states with more flexibility in determining the essential health benefits that insurers must offer, starting in 2020. While carriers must still provide the 10 broad categories of essential health benefits mandated by Obamacare, states could give them more leeway in selecting which specific services to cover.

Consumer advocates, however, worry that this will allow insurers to trim services that sicker enrollees need, leaving them with fewer benefits and higher out-of-pocket costs. For instance, states could allow insurers to limit the number of physical therapy visits or tighten the variety of drugs covered under the plan.

Ultimately, it could lead to less generous coverage, said Elizabeth Carpenter, a senior vice president at Avalere Health, a consulting firm.

Also, consumers next year will face out-of-pocket spending caps of $7,900 for individuals and $15,800 for families, an increase of 7%. That's the biggest jump since 2014, according to Avalere.

Related: What Trump doesn't get about Obamacare and health insurers' profits

The rule also eliminates the standardized "simple choice" plans that the Obama administration had introduced in 2017 to make it easier for consumers to shop. These plans got preferential display on healthcare.gov. Trump officials said that insurers complained the better billing on the federal exchange, healthcare.gov, limited enrollment in other plans and removed the incentive to offer a greater variety of coverage options.

Some enrollees who receive premium subsidies may also have to provide more documentation to prove their eligibility. Exchanges will have to implement "stronger checks" to verify consumers' earnings if other data sources, such as the Internal Revenue Service, show the enrollees' income is actually below the poverty line, rendering them ineligible. Also, those who fail to file taxes and reconcile any past overpayment of subsidies will lose their assistance, even if their exchange doesn't send them a notice first.

The rule also allows states to make it easier for insurers to spend less of the premiums they collect on policyholders and put more toward profits and administrative costs. And the administration raised the default threshold that trigger state reviews of insurers' proposed rate hikes to 15%, up from 10%.

Related: People with pre-existing conditions could face tough times ahead

The administration is also making more changes to the Navigator program, which helps enrollees sign up for coverage on the exchanges and for Medicaid. The rule removes the requirement that each exchange must have at least two navigators and that one must be a community nonprofit group. Also, navigators will no longer have to maintain a physical presence in the area.

The administration cut funding for the Navigator program by 41% during the 2018 open enrollment season.

The new rule is the latest effort by the administration to undermine the Affordable Care Act. Earlier this year, it proposed rules that would allow insurers to sell short-term insurance plans, which last just under a year but don't have to comply with Obamacare's regulations, and to make it easier for small businesses to band together to offer coverage that doesn't adhere to all of the health reform law's mandates. Both of these options could have lower premiums, but also cover fewer benefits.

Mississippi Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 61125

Reported Deaths: 1711
CountyConfirmedDeaths
Hinds5269106
DeSoto332627
Madison229756
Harrison215232
Rankin214628
Jackson199434
Jones177457
Forrest164053
Washington149232
Lauderdale132988
Lee123930
Neshoba119788
Lamar112112
Oktibbeha105435
Lowndes98932
Warren96427
Scott95517
Bolivar94832
Copiah91724
Panola91211
Sunflower90822
Lafayette88111
Holmes84747
Leflore84059
Pike83232
Grenada81320
Yazoo78611
Leake76825
Lincoln74540
Pontotoc7377
Wayne73321
Simpson71227
Monroe70250
Coahoma66310
Tate65023
Marion60118
Covington58811
Adams58425
Marshall5718
Winston57115
George5475
Union53113
Newton51611
Attala49824
Tallahatchie49310
Pearl River48536
Walthall45318
Chickasaw43819
Noxubee41910
Claiborne40013
Smith38013
Calhoun3788
Jasper3768
Clay37013
Alcorn3574
Prentiss3426
Hancock33614
Tishomingo3204
Lawrence3135
Tippah31212
Yalobusha31210
Itawamba30710
Clarke30025
Montgomery2933
Tunica2786
Humphreys27111
Carroll24511
Greene22611
Quitman2251
Kemper22315
Perry2227
Amite2105
Jefferson Davis2026
Webster19912
Jefferson1936
Wilkinson18712
Sharkey1801
Stone1523
Choctaw1274
Benton1250
Franklin1162
Issaquena211
Unassigned00

Alabama Coronavirus Cases

Confirmed Cases: 89927

Reported Deaths: 1580
CountyConfirmedDeaths
Jefferson11859225
Mobile9086191
Montgomery6249143
Madison501425
Tuscaloosa397463
Baldwin321023
Shelby305032
Marshall296630
Unassigned273453
Lee250540
Morgan222315
Etowah193026
DeKalb170113
Elmore160237
Calhoun15609
Walker147063
Houston131912
Dallas128823
Russell12331
St. Clair121712
Franklin119620
Limestone119613
Cullman114111
Colbert109312
Lauderdale107112
Autauga102420
Escambia97915
Talladega91813
Jackson8283
Chambers82138
Tallapoosa81478
Dale78520
Butler75235
Blount7363
Chilton7106
Coffee7095
Covington70920
Pike6607
Barbour5635
Lowndes55224
Marion54224
Marengo52014
Clarke4869
Hale45926
Bullock43811
Perry4294
Winston42911
Wilcox4059
Monroe3914
Randolph38810
Bibb3743
Conecuh37310
Pickens3679
Sumter36118
Lawrence3100
Washington31011
Macon30913
Crenshaw2863
Choctaw27412
Henry2453
Cherokee2427
Greene24211
Geneva2320
Clay2175
Lamar1982
Fayette1745
Cleburne1211
Coosa922
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