• What did Henry Aaron mean? (A bleg)

    In a NEJM paper this week , Henry Aaron wrote,

    The ACA’s subsidies fully protect people receiving them through 2017 against growth of health insurance costs beyond specified fractions of income; thereafter, they provide partial protection against premium growth.

    I either didn’t know this or forgot it. But now I can’t seem to find in the law or anywhere what, exactly, happens to subsidies after 2017. I thought they were tied to the cost of the second lease expensive “silver” rated plan. But then what? Anybody know and have a reference?


    • I couldn’t find a solid reference and the CRS report on premium credits ) mentions no change in 2017.

      However, I wanted to recommend a good way to search through the law. Enter this into Google (without the quotes):

      “site:http://en.wikisource.org/wiki/Patient_Protection_and_Affordable_Care_Act/ [YOUR QUERY HERE]”

      The full text of PPACA is available as HTML on wikisource and Google’s “site” operator will restrict the query to sub-domains.

      “site:http://en.wikisource.org/wiki/Patient_Protection_and_Affordable_Care_Act/ 2017 premiums” yields only 14 results, none of which seem to describe premium credit changes.

      • Jake, thanks. I did pretty much the same search you did, though not using Wikisource. That’s handy!

        I have sent emails to a former CBO analyst who was involved in scoring the law and to Henry Aaron himself. If one or the other gets back to me, I’m sure to get to the bottom of this.

    • See footnote #8 in the CRS paper. Cite below and the section that follows it spells it out even more.

      ‘‘(II) ADDITIONAL ADJUSTMENT.—Except as provided
      in subclause (III), in the case of any calendar
      year after 2018, the percentages described in subclause
      (I) shall, in addition to the adjustment
      under subclause (I), be adjusted to reflect the
      excess (if any) of the rate of premium growth estimated
      under subclause (I) for the preceding calendar
      year over the rate of growth in the consumer
      price index for the preceding calendar year.