Supreme Court's Ruling Concerning Health Insurance Exchanges and Tax Credits, and Its Implications

2015 ◽  
Vol 32 (9) ◽  
pp. 4-5
Author(s):  
Mark Merlis

Proposals to provide or subsidize health insurance for low-income families must take account of the fact that many workers have access to employer-sponsored insurance (ESI), but decline it because of required employee premium contributions. This article considers a tax credit for the employee share of ESI in the context of a broader program of income-based health insurance tax credits. Helping uninsured workers pay for available ESI could be more cost-effective than subsidizing their coverage in the nongroup market. The credit would also be available to workers who were already covered, both for equity reasons and to reduce the incentives for employers to drop coverage or for workers to shift to subsidized individual plans. One key issue is how to prevent employers from reducing their current health plan contributions to take advantage of the new funding. Other design questions considered by the article include whether workers should be able to choose between ESI and nongroup coverage, whether minimum benefit standards should apply for employer plans, and how to achieve a fair balance in subsidies for group and nongroup coverage.


BMJ ◽  
2013 ◽  
Vol 347 (aug19 1) ◽  
pp. f5179-f5179
Author(s):  
M. McCarthy
Keyword(s):  

Author(s):  
Beth C. Fuchs

The Federal Employees Health Benefits Program (FEHBP) could be combined with health insurance tax credits to extend coverage to the uninsured. An extended FEHBP, or “E-FEHBP,” would be open to all individuals who were not covered through work or public programs and who also were eligible for the tax credits on the basis of income. E-FEHBP also would be open to employees of very small firms, regardless of their eligibility for tax credits. Most plans available to FEHBP participants would be required to offer enrollment to E-FEHBP participants, although premiums would be rated separately. High-risk individuals would be diverted to a separate high-risk pool, the cost of which would be subsidized by the federal government. E-FEHBP would be administered by the states, or if a state declined, by an entity that contracted with the Office of Personnel Management. While E-FEHBP would provide group insurance to people who otherwise could not get it, premiums could exceed the tax-credit amount and some people still might find the coverage unaffordable.


Significance A congressional battle looms over Biden’s healthcare reform plans: elements are opposed by Republicans and progressive Democrats. Biden proposes to offer federally provided health insurance to all US citizens. Impacts Biden will use subsequent COVID-19 aid packages to advance his healthcare agenda, including funding community health centres. Biden will likely push to allow more medicine purchases from abroad, creating an opportunity for European and Asian pharma firms. Healthcare tax credits would make private healthcare more attractive and affordable for consumers. A public health insurance option would reduce the insurance risks facing private health insurers. The pharma industry will expend vast sums bankrolling politicians and lobbyists to fight Biden’s healthcare plans.


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