We are sure you’ve been reading about the Federal government shutdown, which started at midnight on October 1st. CLL Society will continue to monitor for impact on our community.
Telehealth Benefits for Medicare Patients
One important thing to note is that the Medicare telehealth flexibilities expired on September 30, 2025. It was not renewed with the shutdown, reverting to pre-pandemic days. Only beneficiaries in rural areas will be eligible to travel to a qualified originating site to receive telehealth services. No Medicare beneficiaries will be able to receive telehealth services at home. Additionally, audio-only services will not be covered.
For chronic lymphocytic leukemia patients, the value of online visits was not only a convenience and cost saving. It allowed distant consultation with an expert who was otherwise not easily accessible, provided access to top specialists for underserved patients not near academic centers, and lowered their risk of exposure to COVID-19 and hospital pathogens, potentially more dangerous in immunocompromised CLL patients.
This is the first shutdown since 2019, and notably, the Affordable Care Act is the reason both times.
Under negotiation is whether to extend enhanced income-based subsidies adopted during the pandemic for ACA insurance customers. Democrats say they want to permanently extend the subsidies, which expire at year’s end, to prevent millions from losing their insurance. Republicans, who have not supported Obamacare, are divided over an extension and reluctant to negotiate.
What Are the ACA Insurance Subsidies?
Income-based subsidies help low-income Americans defray the costs of health care on the ACA insurance exchanges (people earning less than 400 percent of the federal poverty level). Some with very low incomes are permitted to get a plan for free. However, a more recent change lifted the income cap for subsidies, so that no one would pay more than eight percent of their household income on health insurance.
Obamacare signups surged, and the recently enacted Inflation Reduction Act (IRA) extended the subsidies through 2025.
At stake is a decision to let these enhanced subsidies expire. The pre-existing subsidies would remain in place.
By some estimates, it could increase for some from $888 to $1,904 next year if the enhanced subsidies expire.
Almost all people on the insurance exchanges now get a subsidy.
Open enrollment for Obamacare plans starts on November 1st.
We will continue to monitor and report on implications relevant to our community.
