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Everything from insulin to GLP drugs all made more affordable due to President Trump. Facts.


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CMS unveiled new payment model to expand GLP-1 access and lower costs

Public notice: We have hundreds of clients who have failed to review their health insurance options for 2026. All policies will automatically renew in accordance with Federal law.

If you are drafted hundreds or thousands more in the next few days - we can not help you. Everyone has been emailed , called and the insurer has also notified all clients.

We are not responsible for your billing.
You have one day left to try to reach us for a full rate review.

If not, G-d speed we wish you the best.

Joe & Hellen
281-747-9800

Just approved! PPO plan. For those making too much for ObamaCare and NOT needing pre existing coverage. Great rates! Message me to see if you qualify. Ethical brokers welcome top contracts.

GOOD NEWS! ACA Marketplace rates are better than expected this year — if your household income is under 400% of the Federal Poverty Level (FPL). Call now 281-747-9800

Low cost plans if your income is under:
💡 1-person household: $62,600
💡 2-person household: $84,600
💡 3-person household: $106,600
💡 4-person household: $128,600

Some plans are as low as $0 to under $100 per month, depending on your income, household size, and zip code. Call for a quote.

Ask about dental plans. Any dentist. Up to $5000 in benefits. Affordable rates.

Good news. If you make under about 35k I can likely get you $0 health insurance.
Ask me how.

Understanding the ACA “Subsidy Cliff” and the 400% FPL Cap

Why Millions Could Lose Affordable Coverage Without Action

For years, the Affordable Care Act (ACA), also known as “Obamacare,” has helped millions of Americans afford quality health coverage through income-based premium subsidies. These subsidies are designed to cap the percentage of your income you must spend on health insurance premiums.

Under current law (thanks to temporary COVID-era reforms), no household pays more than 8.5% of their modified adjusted gross income (MAGI) for a benchmark Silver plan. However, when the expanded subsidy provision expires on December 31, 2025, the old rules will return—reinstating what’s known as the “subsidy cliff.”

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What Is the 400% FPL Subsidy Cliff?

The term “subsidy cliff” refers to the ACA’s original design, where premium tax credits were only available to individuals and families earning up to 400% of the Federal Poverty Level (FPL). Anyone earning even $1 above that threshold immediately lost all subsidy eligibility, regardless of how expensive their health insurance premiums were.

Example:
• A family of four earning $120,000 (roughly 430% of FPL) could lose all financial assistance under the old rule.
• That same family today, under the temporary 8.5% income cap, may pay around $850 per month for ACA coverage.
• Once the subsidy cliff returns, that same family could pay $2,000–$3,000+ per month for the same plan—an unsustainable jump for many middle-class households.

This is why many experts and brokers call it the most unfair flaw in the ACA design—it doesn’t adjust for regional costs, age, or actual plan pricing.

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Current Rule: The 8.5% Income Cap

Under the American Rescue Plan Act and extended by the Inflation Reduction Act, the ACA temporarily replaced the 400% FPL cap with a simple rule:
No one pays more than 8.5% of their income for the benchmark Silver plan.

This sliding-scale model made coverage affordable for millions of middle-income Americans, including many self-employed families and early retirees. Unless Congress acts, the 8.5% cap expires after plan year 2025, returning us to the subsidy cliff.

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Important: Pre-Existing Conditions and Prescription Coverage

If you have any pre-existing health condition or take prescription medications, you must stay with either:
• An ACA Marketplace plan, or
• An employer-sponsored health plan

These are the only types of coverage legally required to cover pre-existing conditions and essential benefits such as maternity, mental health, and prescriptions.

⚠️ No alternative or short-term plan should ever be recommended or sold to anyone who requires ongoing care or prescription medications.

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Alternative Option #1: Short-Term Health Insurance

Short-term medical plans are a legitimate form of health insurance regulated by the Texas Department of Insurance. These plans can last from 30 days up to one year, and in some cases, can be renewed for up to three years.

Key Features:
• Must qualify based on medical underwriting
• Do not cover pre-existing conditions or maternity
• Primarily designed for catastrophic coverage
• Typically 10–35% cheaper than ACA plans
• Can be canceled or non-renewed at the insurer’s discretion

These plans are best suited for healthy individuals between jobs or waiting for group coverage—not as a long-term solution.

⸻

Alternative Option #2: Christian Health Ministry Plans

Christian sharing ministries are not insurance and not regulated by any state insurance department. Instead, members contribute to each other’s medical bills as part of a shared religious commitment.

Important Considerations:
• Must meet lifestyle and belief requirements
• No guaranteed payment of claims
• Pre-existing conditions often excluded or limited
• Typically about half the cost of ACA plans

These programs can work for very healthy individuals with no prescriptions, but they require deep understanding of their limitations.

⸻

Alternative Option #3: Small-Group Employer Plans

If you’re self-employed, there’s another path: form a small group.

If you operate as an LLC, S-Corp, or Inc. and run payroll for two or more employees (even a spouse), you can often qualify for small-group health insurance—the same type offered by large employers.

Benefits:
• Real, fully regulated insurance
• Often includes nationwide PPO networks
• Better access to hospitals and specialists

Drawbacks:
• Typically higher cost than ACA plans
• Must maintain payroll and business documentation

For many small business owners, this can be the bridge between affordability and comprehensive coverage.

⸻

Alternatives to Avoid
1. “Private PPO” or “Individual PPO” Plans on Social Media
These often claim to use Blue Cross or Cigna networks but are not actually issued by those companies. Many operate in a legal gray area, sometimes creating fake “employer groups” to sell unregulated plans. These are not guaranteed renewable and can drop coverage if you become ill.
2. Limited Fixed Indemnity Plans
These pay set dollar amounts per condition (e.g., $500 per hospital day) but do not cover major expenses and exclude pre-existing conditions. They were never meant to replace real insurance.
3. Going Uninsured
This is the worst choice of all. A single medical emergency can create six-figure bills. If your income is near the subsidy threshold, work with your CPA and your broker to see if you can reduce taxable income below 400% FPL and qualify for a subsidized ACA plan that covers all pre-existing conditions.

⸻

Final Thoughts

As the 2025 ACA open enrollment approaches, understanding these differences is critical. The expiration of the 8.5% income cap could cause millions of Americans to fall off the “subsidy cliff” and face unaffordable premiums unless Congress acts to extend or reform the law.

Until then, work with a licensed, experienced brokerage that understands both ACA and private-market alternatives. Choosing the wrong type of coverage could be one of the most expensive mistakes of your life.

⸻

TXInsurance.com Agency LLC
Helping Texans navigate Medicare, Marketplace, and private health options for over 20 years.
📞 281-747-9800
🌐 www.TXInsurance.com

OPEN ENROLLMENT BEGINS NOVEMBER 1
MESSAGE TO SCHEDULE APPOINTMENT

⸻

HealthSherpa | Fast, Easy ACA Enrollment Start enrolling faster with HealthSherpa, the largest ACA quoting and enrollment platform for agents and agencies.

.**FOR IMMEDIATE RELEASE**

**Bipartisan Obamacare Fix Protects Families and Taxpayers — No New Debt, Stable Rates**

**By Joseph “JP” Stevens, Katy, Texas**
**October 12, 2025**

**Katy, Texas** — A new bipartisan proposal is gaining traction as a *common-sense fix* to the Affordable Care Act (ACA), designed to safeguard both taxpayers and working families. The plan addresses the looming “subsidy cliff” set to hit when enhanced ACA tax credits expire on **December 31, 2025**.

This proposal ensures that **no new federal debt is incurred and that rates remain stable**, while preserving affordable coverage for Americans who have seen premiums rise dramatically in recent years.

“This is a practical, good-faith fix that both sides can support,” said **Joseph “JP” Stevens**, owner of **TXInsurance.Com Agency LLC — a full-service health and Medicare brokerage**. “We can protect working families from crushing premium hikes without adding a single dollar to the national debt. It’s about fairness, affordability, and fiscal restraint.”

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📈 **The Impact: A Real Example of the Subsidy Cliff**

Without congressional action, millions of middle-class Americans will face massive premium increases starting in **January 2026**. By some estimates, premiums could rise an **average of 114%** for those losing eligibility for ACA tax credits.

For example, a **family of four in Savannah, Georgia**, earning approximately **$129,000 per year**, currently pays about **$940 per month** for ACA coverage after tax credits. When the expanded subsidies expire, that same family’s premium would jump to around **$4,089 per month** — an increase of more than **$37,000 per year**.

While it may be possible to choose lower-cost plans, those options often come with **narrower provider networks** or **reduced prescription coverage**, forcing families to give up trusted doctors and essential medications.

This drastic increase happens solely because the family’s income exceeds **400% of the Federal Poverty Level (FPL)** — a hard cutoff known as the **“subsidy cliff.”** The bipartisan fix aims to remove this outdated threshold so that no American family faces financial hardship simply for earning slightly above an arbitrary limit.

For **lower-income Americans**, the situation is different but still concerning. Those earning between **$16,000 and $20,000 per year** could see premiums **nearly double** once the expanded tax credits expire. However, even with those increases, many will continue to find **$0-premium options available in most states**, ensuring essential coverage remains accessible. This contrast highlights why **fixing the subsidy cliff** is the most **urgent and bipartisan priority** — while other components of the ACA can be fine-tuned over time to improve fairness and efficiency across all income levels.

---

⚠️ **The Urgency: Time Is Running Out**

With **Open Enrollment beginning November 1**, there is **no time to spare**. Millions of Americans will soon begin choosing 2026 health plans **without knowing if Congress will act**. Enrolling every household now, only to **re-enroll them later** if a fix is passed, is **not practical** and would be **extremely disruptive** to consumers, agents, and carriers alike.

Such confusion could lead to **fewer enrollments**, further **damaging the risk pool** and driving up costs for everyone.

The time to act is **now** — **before Open Enrollment begins**.
**Fix the cliff now.**
**Reopen the government with a clear, bipartisan commitment** to address the remaining issues in a timely and transparent manner.

> “The fix is simple, fair, and ready to go,” Stevens said. “Every day we delay risks chaos in the market and higher costs for families. This is the moment for both parties to lead — together.”

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🏆 **Who Wins With This Solution? Everyone.**

Under this proposal, **everyone wins**:

* **Taxpayers** — because not one dime of new spending is required to stabilize the marketplace.
* **The federal government** — because no new debt is created, and in fact, final scoring could even show a **net reduction in long-term federal costs**.
* **President Trump** — who would emerge as the *master negotiator*, consistent with his *Art of the Deal* approach, brokering a bipartisan victory that restores confidence in government cooperation.
* **Democrats** — because they can rightfully claim they protected consumers from devastating premium spikes that could have forced millions to drop coverage.

This solution delivers the rarest outcome in modern politics: **a genuine win-win** for both sides, achieved without new debt, without new bureaucracy, and with **stable rates** for hardworking American families.

---

💡 **But Wait — How Does This Not Add Any New Debt?**

Removing the **400% Federal Poverty Level cap** and keeping the **8.5% of income limit** for household contributions will indeed cost money — at least initially. However, this is a **temporary stabilization measure** designed to prevent a market collapse while Congress finalizes a fair, phased solution.

In future years, a **sliding-scale contribution** can be implemented — perhaps gradually rising to **10–12% of income** for higher earners — to ensure long-term fiscal balance. Should someone making **$300,000 per year** receive a subsidy? That depends — perhaps yes if they have **eight children**, but not for a **retired couple**. These nuances can be debated and refined over time.

The immediate goal is **stability for 2026**, keeping the contribution limit at **8.5%** while lawmakers work toward a **phased, bipartisan compromise** that transitions to a fair sliding scale.

But wait — doesn’t that still cost money? **Yes — but far less than it appears.** Any short-term increase in federal subsidy spending can easily be **offset by modest adjustments** or **targeted revenue mechanisms** once the final cost is scored. Those options are numerous and practical — beyond the scope of this announcement, but **not difficult to achieve**.

---

Stevens emphasized that this proposal is a **stabilization mechanism**, allowing Congress time to develop a longer-term, sustainable healthcare framework — one that increases choice, competition, and affordability without punishing success or expanding debt.

> “Correcting the subsidy cliff is just step one,” Stevens added. “Once we stabilize the system, both parties can collaborate on a better, more resilient healthcare model that works for all Americans.”

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**About Joseph “JP” Stevens**

Joseph “JP” Stevens is the owner of **TXInsurance.Com Agency LLC**, a full-service health and Medicare brokerage based in Katy, Texas. The agency specializes in ACA (Obamacare) plans, Medicare Advantage, Medicare Supplement, and other individual and group health insurance solutions.

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**Media Contact**

**Joseph “JP” Stevens**
TXInsurance.Com Agency LLC
📍 Katy, Texas
📧 **[[email protected]](mailto:[email protected])**
📞 **281-747-9800**
🌐 **[www.TXInsurance.com](http://www.TXInsurance.com)**

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