Organizations Allowed to Pay Enrollees Premiums

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The Affordable Care Act’s main goal is to provide access to healthcare.  Public and private organizations that know consumers may have difficulty paying the premiums for coverage purchased on the public exchange if consumers are under financial or health stresses are looking to help.  Officials at the Center for Consumer Information & Insurance Oversight clarified the rules for paying patients premiums in some FAQs.

Originally, private organizations were discouraged from paying premiums on individuals behalf as subsidies on the public exchange already offset the cost of insurance for many, and there was some concern it would skew the risk pool.

Under the Affordable Care Act, indian tribes and tribal organizations have permission to pay premiums for members on the public exchange.  Additionally, private organizations can pay individual’s premiums if they base support on the individual’s finances not their health.  For example, a hospital may choose to pay an individuals premium on the public exchange rather than not be paid at all for rendering services to that individual.  These private organizations are also encouraged to pay an individual’s premiums for an entire year rather than a portion.