The Big Obamacare Subsidy Is Changing: What It Means for Your Family Before November 1

For a few weeks now the phone has been ringing with the same sentence: 'Mario, they told me the big Obamacare subsidy is gone.' Some heard it on the news, others got a forwarded video on WhatsApp, and almost everyone calls with the same fear: that on November 1 their family will be left without health coverage and with no way to pay for it. It is worth sitting down for a minute and separating three things people keep mixing together: what can really change, what stays exactly the same, and what nobody, not me and not the man in the video, can tell you yet.

Here is something you may not expect from an insurance agent: I do not know what you are going to pay next year. Nobody does until your actual case goes into the Marketplace with your estimated income and the number of people living in your household. Financial help on an ACA plan is not a list price, it is a calculation, and that calculation changes from family to family. So when somebody throws a number at you over the phone without looking at your situation, that is not information, that is guessing. And guessing with a family budget is not something I am willing to do.

What can change and what does not

What can move is the amount of help your household qualifies for, and therefore the premium you will see on the screen when it is time to enroll. It might stay close to what you pay now. It might go up. That depends on rules I do not write and on your particular situation. What does not move is the part that calms people down the most when they sit in front of me: the protection the law gives to anyone who is already sick. That is exactly why you should review your case this year instead of renewing on autopilot and getting the surprise in January, when there is almost no room left to fix it.

• No Marketplace plan can turn you down or charge you more for a preexisting condition. That is the law and it still stands.
• Help is still calculated from your estimated yearly income and the size of your household. That mechanism does not disappear.
• Many Hispanic families qualify to pay $0 or close to $0 a month, if they qualify. It is not automatic, it is not for everyone, and I do not promise it to anyone.
• If your income changed this year (more hours, fewer hours, a small business you just started), reporting it on time can affect your calculation more than any headline.

The dates you actually need to write down

Federal open enrollment runs from November 1 to January 15. Outside those dates you can only get in through a Special Enrollment Period, which opens because of a life change (losing coverage from your job or moving to another state, for example) and lasts 60 days. I am not saying this to rush you. I am saying it because I have had people call me on February 3 asking for a plan for their wife, and at that point it does not depend on how much I want to help, it depends on the calendar. October is for doing the math and asking questions. November is for enrolling with real information in hand.

I do not know what you are going to pay next year, and anyone who quotes you a number without seeing your case is guessing.

Before you hand your information to anyone, check who is talking

Every time there is noise around Obamacare, people show up offering to 'fix your subsidy.' Before you give out a single piece of information, ask for three things: full name, license number and NPN. Mine are public and I will repeat them as many times as you need: Texas license #3008095 and NPN 17440153. I am licensed in eight states (Texas, California, Florida, New York, Illinois, Arizona, Virginia and Maryland) and I have been doing this for fifteen years. One more thing worth knowing: my help costs you nothing. If someone asks you for money to enroll you in the Marketplace or to 'process' your subsidy, hang up. If you would rather read all of this calmly before calling, the full guide is at /hablemos-de-obamacare.

Health insurance covers today, not the end

There is something I want to say even though it is not the comfortable part of the conversation. Health insurance covers today: the doctor, the medicine, the emergency. It does not cover the end. When a family calls me because someone passed away, the problem is never the deductible, it is the funeral home asking for full payment before the service. In Texas the average cost of a funeral runs around $9,200 according to the NFDA, and the real quotes I have seen with my clients run from $4,000 to $18,000, depending on the city and what the family decides to do. Meanwhile, around 60% of Hispanic families in Texas have no life insurance at all, according to industry estimates.

That is why, when we review your health plan, I also ask the uncomfortable question: if you were gone tomorrow, what money does your family use? A final expense policy starts at $30 a month, requires no medical exam, is available for ages 30 to 85, and accepts common conditions like diabetes or high blood pressure. Approval usually takes about 48 hours, and the money goes straight to the person you name, without endless paperwork. If what you need to cover is bigger, a mortgage, debts, or the income your family would stop receiving, then we are talking about life insurance starting at $50,000. And for your health plan, the real quote is done with your own numbers at plansaludfamiliar.com, not with an internet average.

All coverage is subject to approval and varies by age, health status and state of residence. Premiums and financial help for ACA plans are determined by the Marketplace based on your estimated income and household size, so no one can guarantee you an amount in advance. This article is informational and does not replace a review of your case.

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