Biden Stimulus Rescue Plan Makes Obamacare Free for Many : The Indicator from Planet Money Millions of Americans are eligible for huge savings on health insurance due to Biden's stimulus plan, but many haven't taken up the offer. Why is it so hard to give people a break on health insurance?

Confusion In The Health Insurance Marketplace

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SYLVIE DOUGLIS, BYLINE: NPR.

(SOUNDBITE OF DROP ELECTRIC SONG, "WAKING UP TO THE FIRE")

STACEY VANEK SMITH, HOST:

This is THE INDICATOR FROM PLANET MONEY. I'm Stacey Vanek Smith. And today I have Dan Weissmann with me. Hi, Dan.

DAN WEISSMANN, BYLINE: Hi, Stacey.

VANEK SMITH: And, Dan, you are the host of a podcast called "An Arm And A Leg," which is all about the cost of health care. Thanks for coming to talk to us on THE INDICATOR.

WEISSMANN: Thank you so much for having me. I have some good news - which, as you can imagine, reporting on the cost of health care, that's not something I get to say every day.

VANEK SMITH: That does not seem like it comes with the territory. So tell us your good news.

WEISSMANN: Remember how four years ago, the Trump administration made a lot of noise about wanting to get rid of Obamacare?

VANEK SMITH: Yes, I do remember that. That was when the late John McCain, Senator John McCain, gave a thumbs down to getting rid of Obamacare.

WEISSMANN: Right, right. Exactly. And it turns out the Biden administration has kind of done the opposite. They actually got Congress to expand a lot of things in Obamacare, but without making a lot of noise about it.

VANEK SMITH: Oh.

WEISSMANN: So kind of buried in the American Rescue Plan - that's this giant stimulus bill Congress passed in March - there's all these ways for a lot of people to save a lot of money on health insurance. For example, millions of people could qualify for basically free health insurance.

VANEK SMITH: Millions of people potentially getting free health insurance sounds like very big news that a lot of people would want to talk about. But I have actually not heard about this until now. Why haven't I heard about it, Dan? Is there like a catch or something?

WEISSMANN: Yeah. Well, I mean, the catch is kind of that you haven't heard about it. And if you heard about it, you might not realize it applies to you. And then, you know, actually signing up is really hard. In some cases, there's experts who couldn't tell you how to do it.

VANEK SMITH: Which is why we brought in our own expert. Thank you for joining us, Dan. Today on the show, health insurance - what is going on with it under the Biden administration? Who is affected? And why you very likely have not heard anything about this.

(SOUNDBITE OF MUSIC)

VANEK SMITH: So, Dan Weissmann from "An Arm And A Leg," we are talking about health insurance. And what I wanted to ask about is, like, how hard is it to give people a break to pay for their health insurance?

WEISSMANN: It can be pretty hard, apparently. So, you know, the biggest break that President Biden's American Rescue Plan is trying to give people on health insurance - it's aimed directly at the people who probably need it most - this one's really hard. So, Stacey, did you know people who get unemployment this year qualify for, like, free Obamacare?

VANEK SMITH: Oh, I did not know that. That's millions and millions of people.

WEISSMANN: Yeah. More than 3 1/2 million people are getting unemployment right now, and more than half a million people have signed up for it every week this year. And theoretically, all of them could qualify for free Obamacare. And I only know about this free health insurance deal because I am a health care nerd. And I follow this health insurance mega nerd on Twitter named Louise Norris. She and her husband own an insurance brokerage in Colorado. These days, she writes about health insurance policy full time. And she says, in theory, you could get this free-health-insurance-on-unemployment deal retroactive to January. But in reality, it's not quite available yet. And that's because the feds have to reprogram healthcare.gov so you can actually sign up. And that is going to take some time.

LOUISE NORRIS: Getting it to where people can just go on the website, click on the button that says I'm receiving unemployment compensation, and boom, they've got their zero-dollar plan. Oh, it's not a flip a switch and it happens sort of thing.

WEISSMANN: They think it's going to take till July to get that going.

VANEK SMITH: OK, well, July's aways (ph) away. What are people going to be doing in the meantime?

WEISSMANN: Well, I talked with a bunch of nerds about this, and none of them had great answers about what you should do to actually get this deal. Some of them said you could try signing up for the right plan, like, you know, guess at answers that would get it for you and kind of hope everything shakes out right in the end.

VANEK SMITH: I mean, that seems like a big question mark. It seems like potentially kind of chaotic. Is there like a silver lining to this situation?

WEISSMANN: It does get better. There's another way to get free Obamacare without being on unemployment. And there's also ways to just save a bunch of money on monthly payments. Stacey, let's take a nerdy little ride here.

VANEK SMITH: I'm always excited about a nerdy ride, Dan.

WEISSMANN: So here we go. Here we go. The first part of this is probably going to sound familiar. Pre-American Rescue Plan, Obamacare already was providing subsidies for health insurance, basically discounts that would depend on your income.

VANEK SMITH: Right. From what I understood, like, you make less money, and your insurance gets cheaper. You pay less for health care.

WEISSMANN: That's exactly right. And sometimes even way cheaper, sometimes even zero. And so the American Rescue Plan did kind of two things to amp that up. And when it made those discounts deeper for a lot of people, and two, it raised the income ceiling - how much money you could make and still qualify for any given discounts. So, like, maybe before, you made too much money to get the very biggest discount and pay zero, maybe now you qualify for it. And maybe before, you made too much money to any discount, maybe now you can get one.

VANEK SMITH: So discounts - like, what kind of discounts are we talking about here?

WEISSMANN: So that depends. This is the super nerdy part. How much money do you make? How old are you? What state do you live in? Are you ready for more questions?

VANEK SMITH: Yes. Bring it on. Let's stay on our nerdy ride.

WEISSMANN: You're ahead of me then, because when I started looking at the actual charts that kind of show all this stuff, I'm like, this is way too complicated. I need an app.

VANEK SMITH: (Laughter) Well, I haven't had to look at the chart. So can you bottom line us?

WEISSMANN: Yes. Yeah. Here's the bottom line - is that some people, like more than a million people, now qualify for a zero-dollar monthly payment and huge discounts on all the out-of-pocket stuff, like whatever you actually get billed for even if you have insurance. If you go to the doctor or the pharmacy or, God forbid, the hospital, normally that kind of stuff without all these extra subsidies can add up to like 10,000 bucks a person, even with insurance.

VANEK SMITH: I mean, that is some significant money.

WEISSMANN: I spoke to Sharon Sibri (ph). She's an insurance broker in the Washington, D.C., area. And she told me, when the American Rescue Plan took effect, the first thing she did was to send all her existing Obamacare clients a text that just said, hey, I'm about to save you a bunch of money. Is that OK by you?

SHARON SIBRI: Once they say, yes, I want my discount, I just go in and do the clicks, and they're done.

VANEK SMITH: And so they all got, like, free insurance? Is that what happened?

WEISSMANN: Well, mostly, no, but they got discounts of - you know, the federal government estimates the average person might save 50 bucks a month on their monthly payment. But some of Sharon's clients did a lot better than that.

SIBRI: If someone was $300, I have seen them come down to as low as a hundred dollars. I had one that was paying 160. They dropped down to $60.

WEISSMANN: So that's a hundred - $200 a month.

SIBRI: Every time I've ran an application, I've been able to smile. I mean, it wasn't like the other years, where I wanted to cry with them. No one has used profanity (laughter).

WEISSMANN: And she says one couple saved more than a thousand dollars on their monthly payment,

SIBRI: Unsubsidized, they were over $2,000 a month. And the husband was like, no way. But I called them back this month, and they got it down to 949.

WEISSMANN: Actually, Sharon called me back after checking her notes. They got it down to $900.38. So that is more than $12,000 a year in savings.

VANEK SMITH: I mean, have you heard from Sharon? Has she gotten any of her clients, like, totally free health insurance?

WEISSMANN: Well, no, because to get that deal, your income has to be really, really low.

SIBRI: Most of the people - because I'm from the D.C. metro area, so you can't really survive on $18,000, $20,000. A lot of people make more than that.

VANEK SMITH: OK, so getting free health insurance - like, that seems like it's going to be pretty rare. Like, your income has to be really, really low.

WEISSMANN: Yeah. It might be kind of rare depending on where you live. That's true. And then there's discounts in there that might not be a good deal for everybody. Like, for instance, I went online to see if my family could get cheaper Obamacare. And it turns out we could, but we don't want it.

VANEK SMITH: Why?

WEISSMANN: With anybody - you know, like we said, with all those big charts, there's a million factors to consider. And some of them are like, are your doctors covered? And if you're switching in the middle of the year, which it now is, you've got to ask yourself, hey, have I already sent money into a deductible? Stacey, you want to nerd out about deductibles?

VANEK SMITH: Oh - I mean, is it important to the story?

(LAUGHTER)

VANEK SMITH: I will say this, Dan. Whenever I've picked out health insurance plans, I basically - mostly just guessing, to be honest.

WEISSMANN: I once did an entire episode about how most of us are going to guess wrong. Like, I talked to an economist who studied it. He quizzes economists. He shows them different plans and says, oh, which one do you think is the best one? And a lot of them get it wrong.

VANEK SMITH: So at least I'm in good company.

WEISSMANN: Yeah, for better or for worse.

VANEK SMITH: (Laughter).

WEISSMANN: I mean, if there's one takeaway here, it's this - if you need to choose health insurance, get help from somebody smart.

VANEK SMITH: And not necessarily an economist. Dan Weissmann is the host of "An Arm And A Leg," a podcast about the cost of health care. Dan, thank you so much for talking with us.

WEISSMANN: Thank you so much for having me.

VANEK SMITH: This episode of THE INDICATOR was produced by Emma Peaslee and fact-checked by Sam Cai. THE INDICATOR is edited by Kate Concannon and is a production of NPR.

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