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2021 News & Updates
What the American Rescue Plan Means For New Yorkers' Access To Health Insurance And Financial Help For Coverage
On March 11, 2021, President Biden signed the American Rescue Plan Act (ARPA) into law. Among other provisions, the ARPA lowers health insurance costs and extends access to health insurance for many people across the income spectrum. In particular, the ARPA: • prevents individuals from having to repay excess PTCs at tax time for the year 2020 • extends PTCs to higher income individuals and households that did not previously qualify for financial help for 2021 and 2022 • ensures that no one will be spending more than 8.5% of their income for health insurance • provides premium assistance for COBRA continuation coverage from April 1 to September 30, 2021, for those who were laid off from work or involuntarily had hours reduced • makes special rules for the handling of unemployment insurance benefits in 2021 for tax purposes and for eligibility for coverage and special subsidies that will likely enable more New Yorkers to qualify for health insurance and subsidies offered through Marketplaces in 2021 • allows taxpayers to exclude up to $10,200 in unemployment insurance (UI) benefits from income in 2020 for the purposes of federal income, which may help low income New Yorkers to qualify for low-cost coverage. This provision is for taxpayers with modified adjusted gross income (AGI) of less than $150,000. You will find more information below about the changes resulting from ARPA that may improve your eligibility for coverage and access to greater financial help in the New York State of Health. There are also additional tips about the changes to your ability to get health insurance coverage that relate COBRA continuation coverage and receipt of unemployment benefits during 2021 resulting from the ARPA. If you are enrolled in health insurance through the New York State of Health and receive financial assistance: • You may be eligible for higher Premium Tax Credits (PTCs). You will likely receive a letter from the New York State of Health about your new larger tax credit amount. • Starting in April, you can update your PTC amount online, through NYS of Health Customer Service Center by calling 1-855-355-5777 or with the help of an enrollment assistor that you can find here or by calling 311 to get information about enrollment assistors in your community, OR • You can wait until June for the New York State of Health to automatically apply the higher tax credit, without any action on your part. • Change in Repayment Obligation ffor Excess PTC for 2020: For tax year 2020, you will not owe a repayment of your excess PTC if your actual income was higher than what you estimated that it would be when you enrolled in coverage. PLEASE NOTE: OCHIA does not offer tax advice. Talk to your tax advisor or check out the IRS fact sheet for more information about your handling of any excess PTC reporting and other obligations. • You may be eligible for PTCs for the first time. • Starting in June, New York State of Health will send you a letter stating your new tax credit amount. If you are not currently enrolled through the New York State of Health: • You may be eligible for higher tax credits than you may have been told before, if you had already started an application but did not enroll in coverage, OR • You may be eligible for tax creditsfc for the first time starting in June. • Head over to the NY State of Health website to enroll in a plan or call the NY State of Health Customer Service Center at 1-855-355-5777 for assistance. If you need the help of a local Enrollment Assistor, you can call 311 to get information about enrollment assistors in your community or you can find one here. If you are not currently enrolled through the New York State of Health and your income is above 400% of the federal poverty level (meaning income over $51, 040 for an individual and $104, 800 for a family of four in New York): • You may be eligible for Premium Tax Credits (PTCs) for the first time. • The law is designed as such that no one will spend more than 8.5% of their income toward health insurance. Tips for New Yorkers who are eligible for COBRA Continuation Coverage If you have elected COBRA continuation coverage and were INVOLUNTARILY laid off or had hours reduced: • You may be eligible for a temporary premium assistance starting April 1, 2021 through September 30, 2021. The premium assistance will be paid directly to the employer such that the employee will not have to pay any COBRA premium or administrative fees during this period in 2021. • You may also be eligible for this premium assistance if: • This premium assistance will be available for you, your spouse, and any dependents on your coverage. • This premium assistance is not available to those who are eligible for Medicare or another group health plan. • If you are eligible, employers and group health plans must provide you with: o a general notice of qualification; o a notice when your premium assistance will expire. This notice must include the date of the expiration and explain that you may be eligible for coverage without any premium assistance through COBRA continuation coverage or coverage through Medicaid or the Health Insurance Marketplace. This notice must be provided to you 15-45 days before your premium assistance expires. • These notices should come to you with the necessary forms for establishing eligibility for premium assistance. You must fill out and send those forms back within 60 days after the notice is provided if you want the premium assistance. • If you do not receive a notice from your employer but believe that you are eligible for the premium assistance, you should submit a request form to your employer. • For more information and Frequently Asked Questions on the COBRA premium assistance, check out the Department of Labor's website. Tips for New Yorkers who are Eligible for Unemployment Insurance Benefits in 2021 and for Those Who Had Received Such Benefits in 2020 The ARPA extends the federal supplement of $300 per week to state unemployment insurance (UI) benefits through September 6, 2021. It also allows taxpayers to exclude up to $10,200 in UI benefits from income in 2020 for the purposes of federal income tax. This provision applies to taxpayers with modified adjusted gross income under $150,000. The ARPA further provides for enhanced Marketplace subsidies for health insurance for people who receive or are approved to receive UI benefits during any week in 2021. Special rules are in effect during 2021 for UI benefit recipients who apply for these subsidies when seeking health insurance coverage through Marketplaces, namely: 1. Household income in excess of 133% of the Federal Poverty Level (in New York, this means over $17,131 annually for an individual and over $35, 245 annually for a family of four) for the purposes of determining eligibility for marketplace premium assistance and cost sharing subsidies. This provision will allow more individuals receiving UI benefits in 2021 to qualify for free or lower cost coverage for 2021. 2. People receiving UI benefits will be considered "applicable taxpayers" during 2021. This will likely allow those receiving UI benefits with very low income to qualify for Marketplace subsidies. 3. The first $10,200 in UI benefits paid to an individual in 2020 are exempted from inclusion in that individual's adjusted gross income for that year. This will lower income that will be counted for the purposes of qualifying for Marketplace premium subsidies. Therefore, people who got coverage through the Marketplaces in 2020 may find that they were eligible for greater premium subsidies than they had claimed during that year. If so, they can receive unclaimed 2020 premium subsidies as a refundable tax credit when they file their 2020 federal income tax return. Those who already filed their 2020 return before the law was enacted should be able to claim the relevant refund as well. PLEASE NOTE: OCHIA does not offer tax advice. Talk to your tax advisor and check out the IRS Tax Tips for information about the plan to recalculate taxes for those receiving UI benefits. You can also review the IRS publication providing guidance about the new exclusion of unemployment compensation made possible through the ARPA. If you are eligible for Unemployment Insurance (UI) in New York State in 2021: • You must have been eligible for UI for at least one week in 2021 to qualify for this type of low-cost health insurance. • You also cannot be eligible for other health insurance such as Medicaid, Medicare, or employer-sponsored coverage. • More details about how to get this coverage will be provided by the New York State of Health as further guidance is provided by the federal government. For more details on what the ARPA means for getting and maintaining coverage if you are receiving UI benefits, check out the NY State of Health regularly for updated information. To shop for a plan, check out the NY State of Health website. If you have specific questions or want to shop for a health insurance plan, call the NY State of Health Customer Service Center at 1-855-355-5777, find a local Enrollment Assistor or call 311 to get information on enrollment assistors in your community. Helpful Links/References Used for This Summary Elizabeth, Down, et al. “ARPA COBRA Subsidy – Special Second Election Period (Two Bites at the Apple and Some Additional Food for Thought).” JD Supra, 5 Apr. 2021, www.jdsupra.com/legalnews/arpa-cobra-subsidy-special-second-5734950/ Last Updated: April 20, 2021 The Latest on The Public Charge Rule As of March 9, 2021, United States Citizenship and Immigration Services (USCIS) is no longer applying the August 2019 public charge rule. USCIS will revert to using 1999 Interim Field Guidance. This older guidance has defined a public charge as someone who relies on cash assistance or institutionalized long-term care from the government. Under this prior guidance, immigrants to the U.S. classified as likely to become a public charge may be denied admission to the U.S. or permission to adjust their status. This means that USCIS is no longer considering an applicant’s receipt of Medicaid (except for long-term institutionalization at the government’s expense), public housing, or Supplemental Nutrition Assistance Program (SNAP) benefits as part of the public charge inadmissibility determination. The only benefits now considered under the Public Charge test are Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF), state and local cash assistance for income maintenance, and institutionalization for long-term care at government expense. The 2019 public charge rule aimed to prevent immigrants from getting a green card or a visa if they used certain public benefits, as listed above, for more than 12 months, in total, within any 36-month period beginning February 24, 2020, or if the federal government believed they would use them in the future. There was a long history of litigation challenging the rule. Many federal courts issued injunctions to block the rule from taking effect during the past two years. However, the United States Department of Justice (DOJ) challenged these court orders, allowing the rule to largely remain in effect throughout 2020. On March 9, 2021, the DOJ withdrew its previous legal challenges to those court orders, allowing a federal court decision from the U.S. District Court for the Northern District of Illinois, which permanently blocked and struck down the rule. The Department of Homeland Security (DHS) has published a final rule removing the 2019 public charge rule from immigration regulations and restoring prior guidance. This withdrawal by DOJ and the rule published by DHS are some of the actions resulting from President Biden's Executive Order on Restoring Faith in our Legal Immigration Systems, which calls for a wholesale review on the 2019 public charge rule and its impacts on immigrant communities and, among other things, aims to ensure that the Federal Government eliminates barriers that prevent immigrants from accessing government services available to them. Guidelines regarding what forms and evidence/documentation that applicants should no longer submit are listed on the USCIS website. For more information, check out the USCIS page and the Mayor’s Office of Immigrant Affairs. For free legal assistance, check out ActionNYC,or call their hotline at 800-354-0365 and say "public charge" Last Updated: April 9, 2021 HRA’s Office of Citywide Health Insurance Access created the new Medicaid and You brochure for seniors and their caretakers. Medicaid and You answers frequently asked questions about Medicaid for seniors and Medicare Savings programs, connects you to helpful resources, and helps you get free enrollment assistance! Last Updated: February 11, 2021
• increases premium tax credits (PTCs) available through the federal and state-based marketplaces for lower- and middle- income individuals and households that already qualify for financial help for 2021 and 2022
Tips for New Yorkers who are Enrolled in the New York State of Health
If you are enrolled through the New York State of Health and do not receive financial assistance:
Tips for New Yorkers who are not Currently Enrolled in the New York State of Health
o you become newly eligible for COBRA coverage over the next 6 months;
o if you could have enrolled in COBRA continuation coverage in the past but did not; or
o if you previously enrolled but discontinued COBRA continuation coverage.
o a notice of this extended COBRA election period to any Assistance Eligible Individual (or anyone who would be an Assistance Eligible Individual if they had elected/maintained COBRA continuation coverage) who had a qualifying event either a reduction of hours or involuntary termination of employment) before April 1, 2021; and
The enhanced Marketplace subsidies for UI benefit recipients are available only for the 2021 coverage year. People receiving UI benefits will still have to meet all other Marketplace requirements to be eligible for the subsidies.
• You may be able to get a low-cost health plan that will last you through all of 2021.
Keith, Katie. “Guidance on Tax Credit Reconciliation, COBRA Subsidies Under American Rescue Plan: Health Affairs Blog.” Health Affairs, 12 Apr. 2021, www.healthaffairs.org/do/10.1377/hblog20210412.744811/full/
Keith, Katie. “New ACA Subsidies Available on April 1: Health Affairs Blog.” Health Affairs, 17 Mar. 2021, www.healthaffairs.org/do/10.1377/hblog20210316.222833/full/#:~:text=The%20new%20law%20extends%20ACA,2021)%3B%20and%20prevents%20individuals
Luhby, Tami. “New Stimulus Obamacare Subsidies Start April 1.” CNN, Cable News Network, 31 Mar. 2021, www.cnn.com/2021/03/31/politics/affordable-care-act-subsidies-stimulus-april-1/index.html
Pollitz, Karen. “How the American Rescue Plan Will Improve Affordability of Private Health Coverage.” Kaiser Family Foundation, 17 Mar. 2021, www.kff.org/health-reform/issue-brief/how-the-american-rescue-plan-will-improve-affordability-of-private-health-coverage/