After a few years of insurance mandates, tax penalties and rising premiums, insureds are wondering what the future holds for healthcare for their own household. The question of the day is: How will the election affect my insurance premium?
To begin, it helps to understand why politics affects healthcare in the U.S. The passage of the Affordable Care Act (ACA) in 2010 set in motion a series of federal laws that began to regulate the availability, coverage, pricing and business practices of health insurance products and the companies that offer them. This transferred an enormous amount of control to federal agencies, as the healthcare industry amounts to nearly 1/6th of the U.S. economy. In the very least, the ACA impacts businesses and individuals to file required tax forms, make purchases to avoid tax penalties and to narrow the time periods in which individuals and families may purchase coverage. Additional impacts were made as the law demanded payments to the government by pharmaceutical companies and health insurance carriers and taxed medical supplies. Medical practices, doctors’ offices of all kinds and hospitals were compelled to make changes in their practices, a shift which also impacted patient experiences. Part of the ACA also made demands on the Medicaid programs of the individual states and prohibited those eligible for Medicaid from receiving tax credit subsidies.
Unfortunately, the results of the first few years of ACA implementation have not had a positive impact on the healthcare of many Americans. As can be imagined, a law which has so many components, and which gives the federal government so much power over so many different entities, will present a monumental task to those who wish to, in effect, “reform the reform law”. Lawmakers and policy makers have been asking themselves: should the law be completely repealed in order to start over? Or should the most disruptive portions of the law be withdrawn incrementally while the more constructive portions remain?
No matter which path is chosen, these reforms will require action and cooperation by the U.S. Congress. Although congressional members and advisors have been busy considering the options all along, it will be January 2017 before the congress will be seated and will be able to begin the process of addressing healthcare solutions in the U.S.
What do you need to know about healthcare after the election?
- We are currently in the Open Enrollment Period for insurance coverage for the year 2017. Enrollment opened on November 1st, 2016 and will continue until January 31st, 2017. During this time, individuals and families may purchase health plans either in or outside the Healthcare Marketplace Exchange.
- Most taxpayers will face a prorated tax penalty for any months during 2017 in which they do not own health insurance coverage. The penalty is calculated 2 different ways – as a percentage of your household income, and per person. You’ll pay whichever is higher:
Percentage of income: 2.5% of household income, Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace
Per person: $695 per adult, $347.50 per child under 18, Maximum: $2,085
- There are no changes in rates for the current Open Enrollment period. Rates for all plans are submitted and approved before the start of the enrollment period, so the rate increases reported in recent weeks are still the rates in place for the 2017 enrollment period. If you have already been quoted, or already purchased a policy for next year, you received the appropriate rate for this year. If you have not yet purchased coverage, you will not benefit by waiting to enroll in your healthcare policy.
- Existing mandates have already eliminated the exclusion of pre-existing conditions from your individual healthcare coverage. Therefore, you can buy a policy that covers you as soon as you are enrolled.
- Many individuals and families will be eligible for help paying for their premiums, and in some cases, even their copays and deductible. If your income is less than $47,520 as an individual, or less than $97,200 for a family of four, you have options to reduce your healthcare costs. We are quoting these policies and subsidies throughout the enrollment period.
At the close of the 2016 election, Donald J. Trump was announced as the 45th President of the United States, and the House of Representatives and the Senate were declared to be held by Republican representatives. Many voters cast votes expressing dissatisfaction over the ACA “Obamacare”, but the regulations, mandates, penalties and tax rules will still apply throughout this year’s Open Enrollment Period. The new government will not be able to begin reforms for many months.
Working with your knowledgeable insurance agent is the best move you can make to navigate the 2017 Open Enrollment opportunity.