8 questions on the future of the ACA (ObamaCare) and what to expect in 2018
What's going on with Replace and Repeal of the ACA?
As of today it appears none of the Republican bills are going to pass so the ACA will stay intact for now. These were considered ObamaCare “light” and really didn't fix the root of the problem.
What is the root of the problem?
There are many, many issues but one big one is the ACA does not control any medical costs related to hospitals and pharmaceutical companies. Many drugs cost over $200 a month now and some are as much as $5,000 a month plus. In addition a short hospital stay can be $100,000 plus easy. Another huge one is too many sick people and not enough healthy people in the risk pool. IE: the younger healthy people did not sign up.
With no replacement or repeal what's going to happen next?
The insurance companies are losing money so many have left the market and more will follow very soon. Without any competition this drives up costs even further and gives people very little choices. Some US counties will actually have NO coverage available in 2018 and many will have only one insurance carrier available. Large Health Insurance companies like United HealthCare (UHC), Humana, Aetna, and even some Blue Cross organizations have pulled out of markets completely.
Why are the insurance companies losing money and pulling out of markets?
The ACA requires that all insurance companies pay out at least 85% of what they take in or the have to refund the money. The problem is many are paying out 100%, 110%, or even
120%+ of what they take in. When this happens they do not get a refund and they still have to pay back money in places where claims were good. If the ACA was making the insurance companies even a small profit they would stay in but stockholders will not accept this many losses.
What about people that have pre-existing conditions in the future?
A full and flat out repeal would probably take away coverage from some people, but not the majority. However another option could be would be we have one product that you must qualify for (this would be far less expensive) and one that you don't need to qualify for (more costly) but these people could continue to still be offered subsidies to help pay premiums making it affordable.
Do I even have an ACA plan (ObamaCare) now? I don't receive any subsidies so therefore that's not an ObamaCare plan right?
In most cases that's false if you have a private/Non Employer funded plan you probable have ObamaCare whether you know it or not. Most private plans, subsidized or not, are regulated by the ACA/ObamaCare and must be compliant with the law. Just because you don't qualify for a premium subsidy doesn't mean you don't have an ACA plan. If you have let's say a private Blue Cross plan not sponsored or paid for by your Employer there is a very good chance this is an ACA compliant plan.
What other options will be available to me if I don't like the ACA plans in 2018?
The YBAA Health Insurance Exchange currently has and is working with several other carriers to offer additional NON ACA/ObamaCare plans for 2018 and these will be available in most states and counties in the US. These will have far more doctors and hospitals available and at half the cost of ObamaCare.
Will I have to pay a tax penalty for buying one of these NON ACA plans?
You should always check with your Accountant on tax matters. President Trump signed an Executive order in Jan, 2017 stating the IRS will NOT enforce the tax penalty for not having an ACA compliant plan.
For a quote and enrollment in the YBAA Health Insurance Plans click here.
April 4, 2018
John Adey, ABYC President, Moderator
3 CPYB Recertification Credits