Cost-Sharing Subsidies

In addition to premium subsidies, some individuals are also eligible for cost- sharing subsidies. Recall that if you selected a silver plan, you were respon- sible for 30 percent of the actuarily determined claims costs. Thus, you faced deductibles and copayments. However, if you had income no greater than 250 percent of the FPL, you faced smaller cost-sharing requirements when you used health services.

• 100–150 percent of FPL: 6 percent cost sharing • 150–200 percent of FPL: 13 percent cost sharing • 200–250 percent of FPL: 27 percent cost sharing • >250 percent of FPL: 30 percent cost sharing

Thus, if you had household income between 100 and 150 percent, you only had to pay 6 percent of actuarily expected claims costs as deductibles or copays. This subsidy is only available if you purchased a silver plan.

The Republican Congress challenged the Obama administration in court over whether the Congress had authorized the funding for these cost- sharing subsidies. While the case was pending in autumn 2017, the Trump administration indicated that it did not have the legal authority to make these payments and stopped them. This change had two implications. First, people in low-income groups continued to be eligible and to receive these subsidies. Second, insurers would not be receiving federal government payments for their enrollees who were eligible.