IF THE GOVERNMENT DEFUNDS OBAMACARE WILL YOU BE COVERED?

If you make your application now, your policy still has to be approved.  It is possible that the insurance companies could decide not to approve you for coverage until Congress works things out.  Remember coverage cannot start until you are approved.

Lets say this process continues to drag on; and, insurance companies tentatively approve your policy contingent upon Congress working things out.  If the policy subsidies promised to the insurance companies are not funded by Congress, it is unclear whether you will be responsible for paying to the insurance companies the subsidies that the government promised.  It will depend upon the contract you sign.  Most of us never review these contracts, yet we are bound by their terms. If the insurance company doesn’t get their money, the terms of the contract will dictate how they proceed.  Some examples of what could happen are:

  1. If you pay only your portion and the government does not pay theirs, the insurance company could cancel your policy for nonpayment.   This would leave you without insurance.  It is unclear whether or not you would personally be on the hook for any money.  That, too, would depend upon the contract you sign.
  2. If you elected to pay for the full premium and then take the subsidy as a tax deduction on your tax return, you should not be cancelled.   It is unclear, if they repeal the Affordable Care Act, whether you could be denied the tax benefit you would otherwise be entitled to.  You did rely on the government’s assurance that you would be able to deduct the subsidy when you acquired the policy.
  3. The insurance companies could decide to cease offering policies on the exchange.  Under this scenario, the insurance company could decide to cancel your coverage and refund any money you paid.

It is possible that, while Washington sorts this all out, the states will step in and make up the difference in any premiums that might be due.  It is possible the insurance companies will decide to wait for their money and not do anything until it becomes clear the subsidies will not be funded.  Under these scenarios, policies  would continue to be offered.  Only if  the government delays the funding until next year or cancels the funding all together, would things change.

It might pay to wait to sign up  for coverage until this gets sorted out.