I was interviewed the other day by a reporter from Watchdog.org. What did I think, she asked, about Obamacare granting subsidized insureds a 90-day “grace period” if they don’t pay premiums?
What? I hadn’t heard of that. Sure enough. More, this grace period is not required for those who don’t receive government help paying premiums.
First, a reasonable requirement for terminating policies. From the Affordable Care Act:
If an enrollee’s coverage in a QHP [Qualified Health Plan] is terminated for any reason, the QHP issuer must: (1) Provide the enrollee with a notice of termination of coverage that includes the reason for termination at least 30 days prior to the last day of coverage…
Fair enough. But if the reason for cancellation is non payment of premiums–and the enrollee is receiving subsidized coverage:
(d) Grace period for recipients of advance payments of the premium tax credit. A QHP issuer must provide a grace period of three consecutive months if an enrollee receiving advance payments of the premium tax credit has previously paid at least one full month’s premium during the benefit year.
During the grace period, the QHP issuer must: (1) Pay all appropriate claims for services rendered to the enrollee during the first month of the grace period and may pend claims for services rendered to the enrollee in the second and third months of the grace period; (2) Notify HHS of such non-payment; and, (3) Notify providers of the possibility for denied claims when an enrollee is in the second and third months of the grace period.
Let’s unpack this: If you receive subsidized coverage and pay 1 month’s premium–and then stop paying–you get guaranteed one month’s free coverage, and after that another two months in which the doctor or hospital will be on the ultimate hook for your care.
And what are the doctors supposed to do if they receive a “pending” notice: Refuse treatment? Hello lawsuit! And what about the taxpayers? The insurance has to keep collecting the subsidies, and then return the money to the government if the grace period expires. Oh, the paper work!
Bottom line: Everyone is responsible for scofflaws’ care except the scofflaws!
Add in the meme that people should make less money to qualify for subsidies, and you have a law that promotes irresponsibility and downward mobility as official policy.
What a mess. For more details, here’s the link to the story, appropriately titled, “Buy 1 Get 3 Free.”, by Tori Richards.