AHCA Premium Age Variation 3:1 vs 5:1 §135 - Tax Credits & Subsidies

AARP vote no on age tax

Age Rates can vary from 3:1 to 5:1 under AHCA

Section 135 AHCA allows a wider gap for rates from 3:1 to 5:1 – See MacArthur Amendment – might allow state waivers to any ratio?

Medical Loss Ratio MLR

Insure Me Kevin.com – How are rates determined

SEC. 135. CHANGE IN PERMISSIBLE AGE VARIATION

Section 2701(a)(1)(A)(iii) of the Public Health Service Act (42 U.S.C. 300gg(a)(1)(A)(iii)), as inserted by section 1201(4) of Public Law 111–148, is amended by inserting after ‘‘3 to 1 for adults (consistent with section 2 2707(c))’’ the following: ‘‘or, for plan years beginning on 3 or after January 1, 2018, as the Secretary may implement through interim final regulation, 5 to 1 for adults (consistent with section 2707(c)) or such other ratio for adults (consistent with section 2707(c)) as the State involved may provide’’.

While an extra charge can be done for smoking, it CA, it isn’t.

(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and

42 U.S. Code § 300gg – Fair health insurance premiums

(a) [1] Prohibiting discriminatory premium rates

(1)In generalWith respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market—

(A)such rate shall vary with respect to the particular plan or coverage involved only by—

(i)

whether such plan or coverage covers an individual or family;

(ii)

rating area, as established in accordance with paragraph (2);

(iii)

age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 300gg–6(c) of this title); and

(iv)

tobacco use, except that such rate shall not vary by more than 1.5 to 1; and

(B)

such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).