Health and Human Services recently released an update on 2020 rules. Only a few changes that directly affect customers.

In addition to a bunch of internal changes (lowering exchange fees and risk adjustment models for example), here are the significant differences for next year:

  1. Cost-sharing amounts paid for RX manufacturer coupons will no longer count towards meeting your out of pocket maximum. Consumers use these to reduce their copays. Medicare and Medicaid consider them kickbacks and ban them, and states are moving to do the same where a generic equivalent exists. This is designed to force people into using generic drugs.
  2. Adjusting for inflation the Out of Pocket maximum on any plan for 2020 to $8,150 indiviual ($16,300 family).
  3. Increasing the training of ACA navigators.
  4. The creation of a new Special Enrollment Period for any household with income loss that would newly be eligible for subsidies.