A lot of the news coverage that you’ll read about regarding coronavirus relief payments and the prospect of a new stimulus check from Democrats who are pushing hard for one relies on a number of important assumptions. One such assumption whenever the media writes or talks about stimulus checks has to do with their source — when people talk about the possibility (the very long-shot possibility, in our judgment) of a fourth stimulus check, in other words, they’re talking about a new payment from the government. Even though that arguably misses a bit of the reality on the ground.
A reality that includes this important fact: Millions of you are about to get a new stimulus check from an unlikely source in the private sector.
Quick question: By a show of hands, how many of you went to the doctor a lot less in 2020 than you otherwise would have? Because you were either worried about being exposed to COVID-19, or because lockdowns meant that some non-critical health care services temporarily weren’t accessible at all, right? At the same time, though, it’s a pretty good bet that you still paid the same amount in health care premiums from one month to the next in 2020. So what does that mean?
It means you probably have a refund coming. According to the Kaiser Family Foundation, private insurers will pay out an estimated $2.1 billion in rebates this year.
Thank the Obama-era Affordable Care Act for that. There’s a provision in that law that mandates that insurers have to spend at least 80% of the revenue they get in the form of premiums that you and I pay on certain things like health care claims. And if they don’t? Then the refunds start flowing. To be more specific, according to the Kaiser Family Foundation, those refunds are calculated based on the share of premium revenues that insurance companies paid out for health care expenses and quality improvement. So if you’re one of the eligible recipients, how much can you expect to get back?
“Not all policy holders are due rebates, but among those who are, this year’s rebates work out to roughly $299 per plan member in the individual market, $127 per member in the small group market and $95 per member in the large group market, according to KFF’s analysis,” the nonprofit notes. “By law, insurance companies must begin issuing the latest rebates to eligible consumers later this fall.”
Those eligible Americans, by the way, number about 10.7 million. It’s also important to point out that the pandemic is not the only reason for this situation, since rebates are calculated based on a three-year average of data from health care insurers. Meanwhile, other key details to know:
Depending on where you live, because of differences in how rebates are calculated, you might get back more or less than the amounts stated above. Also, the rebates are supposed to start going out this fall. Yours could come in the form of a check, but it also might be given to you in the form of a premium credit.