These fixers, officially known as caseworkers, unraveled complex and arcane health insurance rules to solve people’s coverage issues. They worked in a little-known federal department with which most consumers never interact — until they need help.
Consumers who were enrolled fraudulently in Affordable Care Act coverage could receive unexpected tax bills — the first and possibly only clue they were a victim of fraud. Getting help may become difficult as federal workers are laid off and funding for assistance programs is cut.
After leaving his job to launch his own business, an Illinois man opted for a six-month health insurance plan. When he needed a colonoscopy, he thought it would cover most of the bill. Then he learned his plan’s limited benefits would cost him plenty.
The proposal also would reverse a Biden administration policy that allowed “Dreamers” — immigrants in the country illegally who were brought here as children — from qualifying for subsidized ACA coverage.
The Affordable Care Act requires most insurance plans to cover preventive care, including many forms of contraception, without cost to patients — but not if they’re “grandfathered” plans, which predate the law.
The Jan. 28 executive order directs federal regulators to cut insurance coverage for hormonal or surgical treatments that help in young peoples’ gender transitions and cut federal funding for medical professionals or institutions that provide such care. It will likely be challenged in court.
Donald Trump’s first administration advanced rules forcing hospitals and insurers to reveal prices for medical services. Employers don’t want to risk backtracking during Trump’s second administration.
The number of new and returning enrollees using healthcare.gov — the federal marketplace that serves 31 states — is well below last year’s as of early December. Also, a Biden administration push to give “Dreamers” access to Obamacare coverage and subsidies is facing court challenges.
A federal judge sided with 19 states seeking an injunction against a Biden administration rule allowing recipients of Deferred Action for Childhood Arrivals to enroll in Affordable Care Act coverage and qualify for subsidies amid the annual open enrollment period.
The federal government put guardrails in place to limit unauthorized plan sign-ups and switches. But the changes could prove to be a burden to consumers.