What Happens to Cost Assistance if ObamaCare is Repealed?

What is Going to Happen to Tax Credits, Cost-Sharing Reduction, and Medicaid under Trump and the Republican ObamaCare Repeal Plan?

We explain what happens to cost assistance (Tax Credits, CSR, and Medicaid) if ObamaCare is repealed.

This page was written at a time when a repeal and replace plan was being discussed in Congress in 2017, but it should still be relevant in general since repealing the ACA in any year would have the same general effect.

In simple terms, there are only a few things to know about cost assistance under Donald Trump and a GOP controlled Congress.

• First, generally speaking, ObamaCare offers lower costs to those making less than 400% of the poverty level via premium tax credits, cost-sharing reduction subsidies, and Medicaid expansion. The GOP plans to defund or repeal aspects of all these things, and have suggested replacements in the past. See details of how ObamaCare’s cost assistance works. See GOP replacement ideas.
• Republicans have been trying to defund and repeal ObamaCare since it passed. Now that they are in power they have begun a “repeal and delay plan.” This plan begins the defund and repeal process ASAP and delays the implementation of some repeal provisions while a replacement plan is worked on. The details of the full plan are currently uncertain, but the defunding process has already begun. Learn about “repeal and delay.”
• Despite repeal efforts, for now, ObamaCare is still the law of the land here in mid-2017. It is very unlikely that cost assistance would be repealed before 2018 as that would require rescinding promised cost assistance from those who are enrolling now in 2017 before any defund or repeal measures are passed. This applies to both premium tax credits and cost-sharing reduction subsidies. The same should be true for Medicaid expansion. That said, nothing is impossible. We will keep everyone updated.
• The GOP has put plans on the table for cost assistance (they want age based instead of the current income based) and Medicaid (they want to privatize it and make lump sum payments to states, it is currently a public joint state-federal program).

Thus, right now things are uncertain, and it could get very bad for tens of millions of Americans. But that “bad” likely won’t start until 2018 (or later if defund and repeal measures are “delayed”). In the meantime, the GOP could surprise everyone by putting a better plan on the table. Right now their “better plan” isn’t better or agreed on, but at least it is something.

Uncertainty and ambiguity aside, for now, Open Enrollment 2017 was held as scheduled. Expected levels of cost assistance were available to many families making less than 400% of the federal poverty level through the marketplace. Employers must still offer coverage to full-time employees. Insurers can’t deny you, drop your coverage, or charge you more for having a preexisting condition.