Consumer help

What does the announcement about stopping cost-sharing reduction payments to health insurance companies mean? Does that mean my financial assistance stops?

No.

If you enrolled through HealthCare.gov and qualified for a subsidy to lower your premium, you will continue receiving it.

If you qualified for reduced out-of-pocket costs on a silver plan, this announcement does not change your plan and does not change your benefits under the plan. Your reduced deductible, co-pays, and out-of-pocket maximum stay the same.

How will this impact premium subsidies?

The announcement does not address premium subsidies. Premium subsidies help lower the price you pay each month to have coverage through HealthCare.gov, and they are unchanged.

The administration will stop paying another kind of payment that goes to insurance companies that covers some of the out-of-pocket costs for middle-income Oregonians who enroll through HealthCare.gov.

Can the federal government decide to end premium subsidies next?

No. The administration was able end the cost-sharing reduction subsidies because an earlier court ruling permitted it. There is no case or ruling challenging premium subsidies.

How will this affect 2018 plans?

In order to ensure carriers can continue to offer coverage in Oregon, DCBS is ordering health insurance companies offering plans on HealthCare.gov to increase their already approved silver metal tier 2018 plan rates by 7.1 percent.

Non-silver metal tier plan rates (e.g., bronze and gold) will remain unaffected.

This increase will affect plans both on and off HealthCare.gov

Open enrollment for 2018 plans begins Nov. 1 and runs through Dec. 15, 2017. Oregonians are encouraged to work with an agent or community partner to find the best plan for their situation. Due to these additional rate increases on silver metal tier plans, it is especially important to apply for financial assistance through HealthCare.gov.

Does this affect my Medicare or Oregon Health Plan coverage?

No. It affects the plans sold on HealthCare.gov only.

​​​