Updated October 17th, 2017
Bipartisan Obamacare Stabilization Bill Finalized
A bipartisan bill designed to stabilize Obamacare, which was authored by Republican Senator, Lamar Alexander of Tennessee and Democratic Senator Patty Murray of Washington, was finalized today.
One of the most important pieces of the bill relates to the valuable CSR payments that President Trump just announced he would no longer issue to insurance carriers. Despite the President’s announcement, this bipartisan bill would guarantee payment of the Cost Sharing Reduction (CSR) payments owed to insurance carriers under the law through 2019.
Also included in the Lamar-Murray bill is $106 million for marketing of the 2018 open enrollment period, which was also taken away recently by the administration. Open enrollment starts on November 1st and ends on December 15th this year.
The bill also streamlined and expedited the process for states to be approved for 1332 waivers, which is a provision under the ACA law that allows states to create special insurance programs for residents who have certain pre-existing conditions. Alaska has already been awarded this waiver. The bill will also allow states to create a reinsurance program, which would help offset losses by insurance carriers offering coverage in their states.
The likelihood that an Obamacare amendment, as opposed to a repeal and replacement, would successfully pass Congress and the President’s desk were not good. House Speaker, Paul Ryan has been pretty clear that he wouldn’t entertain an Obamacare bill to stabilize the market and President Trump has said on more than occasion that he wants a repeal and replace plan only. Despite that, Trump told the media today at a press conference with Greek Prime Minister Alexis Tsipras that he actually endorsed the bipartisan deal and that the White House was involved in the discussions with Alexander and Murray.
To be continued…
Updated October 13th, 2017
On Friday The 13th President Trump Decided To Gut The Obamacare CSR Payments – It’s a Nightmare For Mainstreet
Oh President Trump, we just don’t know what to say anymore. Rolling back irrational and ineffective regulations on short-term plans makes sense, because it will, in fact, help Americans get access to cheaper coverage year round, we get that. Creating an opportunity for AHP’s to help promote a more competitive market, that’s a great idea as well. Anything that encourages product innovation in such a stagnant industry should be welcomed. Where we draw the line though, is when you now announce that you’re going to no longer make the CSR payments to carriers, as the government is contractually obligated to do.
Sorry not sorry, but just because one party takes control of Congress, it doesn’t mean that they should get to weasel out of following through with the contractual commitments that were already established. The government relies on private companies and contractors to help bring to life the projects, programs, and legislation that they pass. No one is going to want to do business with the government if they think there’s a possibility that the contract will be unwound if and when the other party takes power. Or, as an example of precisely what insurance carriers have done this year, they will price into their bids for government work additional costs because of the uncertainty and risk, simply out of concern that the contract might not be honored at some point. How is this type of approach going to help cut government waste?
The CSR program is not a bailout to insurance carriers, and these are not payments that are going to the Obama Administrations “Pet Insurance Carriers” either. Most of the major insurance carriers were all participating at some level when the ACA launched. The majority of carriers were still losing money even with the CSR funds in place. The remaining insurance carriers trying to make this work can hardly be called pet insurance or favored insurance carriers. They’re the surviving insurance carriers, the ones who are too stubborn to give up on the American people and the ACA. These are clearly insurance carriers that care about not pulling the rug out from underneath people who need healthcare. That’s precisely what you’re proposing to do by deciding to not fund the CSR payments less than a month before the open-enrollment period (OEP) begins. The OEP that has already been cut-in-half by starting on 11/1 and running through 12/15, instead of 1/31/2018.
Without CSR’s in place, approximately 60% of the residents of Florida who receive Obamacare, will be looking at an average rate increase of 44.7%. This figure could actually be higher if the states largest provider were to exit the market or some specific counties. Some carriers in Florida have submitted rate increases of 70% or more.
Without CSR payments, the average rate increase in Georgia will be 54.2%.
Without CSR payments, the average rate increase in Ohio will be 34%.
Without CSR payments, the average rate increase in Virginia will be 57.7%
People’s lives are at risk, and there will be collateral damage if you actually decide to move forward in this manner. Definitively there will be people who require an on-exchange ACA plan, who receive some kind of a subsidy that helps them to afford their health insurance coverage, that will no longer be able to make it work. Some of these people will not be eligible for a short-term health insurance plan, or an association plan. They won’t have coverage, and some of them may die from a lack of access to care.
We are in agreement that the ACA needs to be massively revised. It needs an incredible amount of work in order for healthcare reform to actually become meaningfully better in this country. That said, we just do not see how this course of action leads to anything but more resistance from Democrats on any bipartisan effort, and a whole lot of angry voters in at least four states where votes seem to matter to Republicans.
Announcing that you are not funding the CSR payments at the exact moment Americans need you to do what is best for them the most, it isn’t good politics, it’s just wrong.
Updated October 12, 2017
President Trump Signs Executive Order For Health Insurance Reform
President Trump has signed an executive order that seeks to expand the coverage available to Americans through two primary groups. While the executive order is not very detailed with respect to exact details of how each part of this order should be followed out, it gives each respective governmental department jurisdiction to interpret how the laws should be applied. This is often the language used by executive orders.
- Association Health Plans – AHP’s would give large and small employers the ability to band together to negotiate as a stronger force collectively direct with insurance carriers, in a hope to be able to obtain better rates. Maybe AHP’s could be viewed by millennials as “Groupon for Health Insurance”. Some areas where AHP’s could be problematic is that it could allow, for example, groups to be formed that would have a much more healthy pool of people. The healthier the pool, the lower the risk. Anyone who participates in competitive triathlons and maintains a certain level of physical fitness could theoretically be looking at having access to much less expensive health insurance. Or, if you worked in a certain industry where there is a higher average household income level. Theoretically, you might be able to find an actuary who would be able to determine that all mechanical engineers earning $300,000 or more from Sunnyvale, CA should be priced at a rate that is 80% lower than a factory worker in Corona, CA who makes $55,000 a year. We’ll let that last one percolate a bit, and not create a bias by explaining more. Or lastly, this could be an amazing opportunity for a major online retailer with huge economic clout and some kind of annual membership fee-based business, to offer discounted health insurance to its members. Amazon Health Insurance anyone? Interestingly it seems that Amazon has owned the domain name AmazonHealthInsurance.com since 2007.
- Short Term Health Insurance Plans – These plans are already somewhat popular with consumers who can’t afford an ACA plan, and or who do not receive health insurance through an employer-based plan. They are not compliant with all requirements under the ACA, including pre-existing conditions. What it is believed that President Trump’s executive order will set out to do regarding these plans, is remove the 3-month maximum policy term that was placed on them by the previous administration. This 3-month limit is pointless because it can be circumvented currently, and has been for some time now by brokers and carriers who choose not to follow CMS regulations to the full letter of the law. We’ve found that the 3-month limit has only increased the number of less than reputable companies now offering short-term health insurance. As long as a consumer is well informed about what they are buying, there is little down-side to short-term plans. They’re not a fit if you have significant health issues, or if you plan on becoming pregnant, or are already expecting. They are a fit however for the millions of individuals and families who find themselves falling into the ACA Doughnut hole where a subsidy just isn’t enough to afford coverage. That group has become larger and larger as premiums grow at rates of 15% or higher far outpacing the federal poverty level by leaps and bounds. Removing the three-month limit simply allows more reputable and reliable (IE: not sketchy, or in business for a year and then pfft, they’re gone) companies to provide short-term health plans.
- Health Reimbursement Arrangements – HRA’s allow employers and employees to pull monies from a non-taxable fund that allows for monies to be paid out for some of the costs associated with using coverage. Copays, deductibles and so on. There’s certainly an opportunity for employers to in effect reward healthier risk, and or discourage less healthy employees from participating in plans and or employment. That said it seems a bit extreme that the job market and or employers would have so much ability to weed out employees. You want individuals who can do the job well, not run a marathon.
In closing, we think that as always the devil is in the details, and right now, as you can see below, there’s not too much detail. So we will have to wait and see how each corresponding government agency begins to interpret this executive order. As things stand right now it is estimated that some of these changes could take upwards of six months before they could go into effect.
Updated October 11, 2017
President Trump Expected To Sign Executive Order On Healthcare Thursday
It is rumored that today President Trump will sign an executive order that will loosen restrictions on Association Health Plans, as well as lift the rule that limits short-term health insurance policy from being effective for more than 91 days, or three months.
While we do not believe that short-term health plans offer as robust of a level of coverage, we do think that they can work well for individuals who have limited medical requirements and are looking for something that provides the basics and some level of a safety net, should anything catastrophic happen. If you’re expecting or planning to have a baby, a short-term health plan isn’t for you. If you simply want access to affordable generic prescriptions, annual check-ups, and diagnostic testing, without having to meet a $12,000 deductible first, short-term plans can work. They often cost about 50% or less of an ACA plan as well.
The doughnut hole problem that Medicare has, the ACA has the exact same one, it is just much worse. If you can’t utilize services for basics, like seeing a primary care doctor, or getting an annual check-up without having to meet an absurd deductible first, are you really going to be able to improve your health and well being? Republicans and Democrats are both responsible for sending us down this path where satisfaction rates for health insurance plans are just below wireless providers and cable companies.
It’s a complicated issue, as healthcare always has been, and regarding short-term health plans, we advise that anyone who is interested in any kind of alternative to Obamacare, explore those options with a licensed and reputable health insurance professional. In recent years there has been no shortage of scam-artists selling short-term health products that were either not insurance at all or extremely flimsy plans.
So we’ll even go one step further and say that you should really only be entrusting very large companies when it comes to short-term health insurance.
How The Three Month Limit On Short Term Health Insurance Actually Hurt Consumers
That statement above, or warning really, about only entrusting large established insurance carriers for a short term health plan, is the perfect segway into explaining why we are actually in favor of President Trump removing the restrictions put in place on short-term health plans. When this three-month limit rule went into effect, it made things very difficult for ethical, trust-worthy companies who actually sell quality short-term plans, to continue to operate in the space. Ethical companies with quality products and services, who are trying to do right by the consumer, in a time when that is increasingly difficult, will comply with all applicable state laws and regulations. Sketchy call centers who are just in it for a quick buck, they won’t. So when the previous administration put this law into place, it actually was a giant invitation for the health insurance industries underbelly to swoop in and start ringing their cash registers, at the expense of the consumer.
As a result consumer complaints about short-term plans went up, a number of new entrant insurance carriers selling short-term plans went out of business, and some of the least ethical brokers in the business started creating and selling some even lower quality insurance plans that are not even health insurance.
By eliminating this three-month limit, it will in effect allow the larger ethical insurance carriers to come back into the market in a more meaningful way, and they will be able to not only better serve the consumer who is suffering, but they’ll crush the fly-by-night companies and help clean up the industry.
President Trump’s Executive Order Might Make ACA Carriers Get More Realistic About Plans Basics Benefits
We’re not saying the short term plans are a perfect fit for everyone, nor are we saying that this executive order which will presumably make things easier for association plans to be sold across state lines, is going to make some significant impact. What we are saying, is that this executive order will actually help the industry better serve a segment of the market that isn’t getting a subsidy or a subsidy that is not large enough to be meaningful. It will also help the industry squeeze some of the “here-today but gone-tomorrow” sketchy companies out of the industry. With respect to this weakening the risk pool, there’s already growing concern that because of how high rates have gone, the risk pool has already priced out a significant percentage of the healthier consumers who are less likely to “overpay for coverage” because they are, healthy.
If the health insurance industry and politicians want to get real about lowering costs and making any kind of individual market solution work long term, they really need to do two things, although there’s truthfully about two hundred things that need to be done. Here are two of the most important things they’ll need to address immediately.
- One, they’re going to have to do something about the most costly part of the risk pool, the 55 to 64 year old demographic. More specifically, it will mean lowering the Medicare age to 55 instead of 65.
- Secondly, you will have to give carriers more flexibility to create plans that cover services that all consumers do and do not want to be included. It’s been a divisive issue for many groups, and simply ignoring this issue will not result in any positive outcome.
One other impact the executive order could potentially make is to help convince carriers to begin to be more realistic about deductibles and copays for ACA plans. Because plans that were offered up four years ago when the ACA launched, look vastly different than the ones consumers are complaining about now. There are a number of carriers offering plans, and premium rates are up dramatically, but in all reality, for the majority of Americans on Silver plans with the largest subsidies, they’re not meeting their deductible, not even coming close. How can you expect that someone who is earning $30,000 a year to possibly meet a $12,000 deductible?
Often Americans on ACA plans are paying for the basics out of pocket, including prescriptions. It’s like you have health insurance, but you just can’t afford to use it. It’s a great safety net should you get cancer, or should you get into a car accident, it is just not great if you want to actually use your access to healthcare to actually become more healthy. It is without question a major and fatal flaw in the design of the ACA.
The Affordable Care Act just is not affordable anymore, we have to come to terms with that.
President Trump’s executive order isn’t a death sentence to the ACA, it’s a band-aid that is going to address certain aspects of the market, particularly for this enrollment season. If real healthcare reform is not a real bipartisan effort, if Republicans and Democrats can’t come together to work something out with an approach that takes into account everyone’s viewpoints and needs, then this whole thing is going down anyway.
Updated October 3, 2017
2018 Obamacare Premiums Are Going Up Much Higher Than Anticipated
No one wants to admit when they’re wrong, but we’re going to, even if it means eating some much-deserved crow.
We’re not trying to make light of the terrible scenario that consumers in the United States are facing right now when it comes to their health insurance costs for the 2018 enrollment year. We’re simply a little shocked at what we’re seeing being approved by state insurance commissioners. That said, many of them have indicated that they felt that had little choice but to approve the submitted price increases or face an even greater exodus of insurance carriers from the health insurance marketplace.
Before we get into some of the details on the actually approved rate increases on a state by state basis, we want to make a couple things clear.
- Just because a state has approved a rate, it does not mean that your insurance carrier will increase its plans by that much. There are some smaller carriers who have submitted increases of 90% or more, and that is very extreme, and some of those regional rate submissions are really skewing the average much higher so it looks a lot worse than it actually is. That said, almost none of the rate data is good.
- We have two different rates to compare here. One rate, the higher rate, is reflective of carriers pricing plans in anticipation of not receiving the CSR payments that the government is responsible for providing them with. These are the payments that President Trump’s administration has indicated that they have not made a decision if they will commit to paying them or not. In some cases, for example, like within Florida, approved rate increases would be 13.7% on average if the CSR payments were going to be provided to insurance carriers. Without the CRS payments being made, the average statewide increase is 44.7%. Or, another example Mississippi, in which there’s a 16.1% increase with the CSR payments or a 38% average increase without them.
- These price increases are not going to impact individuals whose health insurance premiums are subsidized by the ACA, either entirely subsidized or mostly. For individuals and families who don’t receive a subsidy, we are sorry to have to say this, but you are really getting the short end of the stick this year.
To most people within the industry and outside of it, the question of should the administration continue making the CSR payments or not, should not be a question in the first place. That said, President Trump has been receiving pressure from members of the Freedom Caucus, and other ultra-conservative groups, to not pay the CSR’s because they perceive them to be a “bailout” for the insurance companies. First of all, financial mechanisms like the CSR’s have always been used when trying to establish a new marketplace.
Secondly, the Freedom Caucus shouldn’t be influencing anyone when it comes to healthcare as they are extremely out-of-touch with reality. After all, one of the Freedom Caucus members once infamously referred to the local emergency room as “the safety net that uninsured Americans” can rely on for healthcare if they can not afford health insurance.
We’re going to go out on a limb here and say that there might be some last minute maneuvering within CMS and the Trump Administration to make efforts to bring premium increases down to reasonable levels wherever possible. One obvious way is to simply make the CSR payments and commit to it.
As of 10/3/2017, only Alaska is seeing a decrease in rates. We will continue to update this list as approved rate averages become available. Or you can now navigate to our 2018 Obamacare Rates page for a full list of each state and its respective premium average adjustments for 2018.
2018 Obamacare Rate Increases By State (As of 10/3/2017)
|STATE||Approved Rate With CSR Payments||Approved Rate Without CSR Payments|
|Alaska 2018 Obamacare Rates||-26.5%||-22%|
|Arkansas 2018 Obamacare Rates||8.5%||17.5%|
|Colorado 2018 Obamacare Rates||26.7%||32.9%|
|Connecticut 2018 Obamacare Rates||21.7%||28.4%|
|Florida 2018 Obamacare Rates||13.7%||44.7%|
|Georgia 2018 Obamacare Rates||31.5%||54.2%|
|Idaho 2018 Obamacare Rates||8.1%||27.0%|
|Louisiana 2018 Obamacare Rates||7.2%||21.4%|
|Maine 2018 Obamacare Rates||20.1%||24.7%|
|Maryland 2018 Obamacare Rates||33.0%||43.8%|
|Michigan 2018 Obamacare Rates||16.8%||26.8%|
|Mississippi 2018 Obamacare Rates||16.1%||38.0%|
|New York 2018 Obamacare Rates||12.8%||13.4%|
|North Dakota 2018 Obamacare Rates||23.3%||28.2%|
|Oregon 2018 Obamacare Rates||9.7%||15.7%|
|South Carolina 2018 Obamacare Rates||11.3%||30.7%|
|South Dakota 2018 Obamacare Rates||15.8%||27.4%|
|Tennessee 2018 Obamacare Rates||13.5%||28.5%|
|Vermont 2018 Obamacare Rates||8.5%||10.5%|
|Virginia 2018 Obamacare Rates||43.4%||57.7%|
|Washington 2018 Obamacare Rates||24.0%||33.0%|
Those rate increases, with or without the CSR payments are brutal. Keep in mind however that not all carriers are going to increase their rates by whatever the state average is.
All that being said, this will most likely be the year in which we break from being unbiased in our advice to consumers. If we’re being pragmatic and just trying to find a way for Americans to gain access to better healthcare at a lower cost, in effect treating others how we would want to be treated, we’re going to advise a lot of people to research all of their options when it comes to health insurance. Even if that means signing up for coverage that doesn’t qualify as an ACA plan, and or Obamacare plan.
Since 2013 we have been advocates not just for consumers, but for the ACA as well, and what the opportunity it represented could mean for tens of millions of American families. Well as we are heading into 2018 we can’t ignore the obvious any longer, it is time to just accept the obvious. Unless someone is 100% subsidized and has some additional coverage to absorb the high deductible costs that ACA plans have, health insurance under the ACA is far too costly for most individuals within the United States.
In the coming days, we will be providing our visitors with information on quality health plans outside of the ACA. These plans are not a fit for every individual, for example, if you have a serious health condition. Statistically, these plans are a great alternative for upwards of 80% of the individuals who currently have ACA plans.
While it might seem like we’re turning our back on Obamacare, we really are not, it is simply the fact that the Affordable Care Act or Obamacare has been undermined and chipped away at since it launched. This has resulted in carriers exiting the exchange, leaving consumers with very limited choices and often with health insurance plans that would have been considered of questionable and or limited quality just four years ago. Many of the lower cost plans have absurdly high deductibles of $10,000 or more and significant co-pays, and it in effect makes these plans great for catastrophic coverage, but little more than that. If you have an ACA plan and you are hospitalized for two months, sure, you’ll be covered and will not be facing bankruptcy, but if $50 or $100 co-pays prevent you from seeing a doctor for routine exams, who is benefiting from this other than an insurance carrier.
Obamacare Alternatives Might Be The Only Way For Individuals And Families Who Are Not Fully Subsidized To Afford Coverage
Seeking to fill this void many families and individuals find themselves within, some companies within the insurance marketplace have designed alternative plans that have lower costs and co-pays, and include many of the basic services that most consumers within the United States actually use, like annual screenings and checkups and low-cost generic prescriptions.
Like with anything in life, there are however some companies and plans that provide little to no value, and that we advise consumers not consider purchasing.
As always we will continue to update Obamacare.net with accurate data and news, and our focus will be on helping people, not on profit or politics.
Updated September 27, 2017
Obamacare Survives Republican Lead Effort To Repeal It – What That Means For Obamacare & Health Insurance Rates For 2017 and 2018
Republicans have now exhausted their efforts to repeal and replace Obamacare, and or simply repeal Obamacare, as unpopular as the latter would be. They had until September 30th to try to gain enough support from the Republican lead Senate, but as of Tuesday evening on September 26th, the consensus amongst Republicans is that their efforts have officially failed. In private most Republicans might admit the truth, that repealing and replacing Obamacare with any of the many proposed versions brought forward, would prove to be a political disaster. No one really wanted “
No one really wanted “Trumpcare” in its various forms brought forward to pass, that is excluding a number of the more extreme members of the party. Individuals who don’t seem to care that all of the proposed legislation to repeal and replace the ACA would have left millions without coverage options, and would have actually increased rates for this open-enrollment. To try to apply logic to that thought-process is about as useful as screaming at wet paint to dry faster.
Trying to force through any bill that wasn’t a nonpartisan effort wasn’t going to end well, and from an optics perspective with the Republican base, they can at least say that they “fought the good fight” and hope to not lose votes from their base for not imploding the healthcare marketplace entirely.
At the end of the day, if Republicans and Democrats don’t take the time to work together on a real way to repeal and replace Obamacare with something better, or allow it to remain in place (in name) but vastly improve on its many flaws, any new healthcare reform will ultimately fail because insurance carriers will not participate. You can’t have better pricing from insurance carriers, hospitals, doctors and drug companies without competition, and the most critical part of that food chain, insurance carriers, will not get involved if healthcare is going to remain a politicized mess.
It is unfortunately probably alarming and disappointing to some of the more hardline Republicans that President Trump is actually willing to listen to and work with, Democrats like Chuck Schumer. That said, isn’t it time for the adults in the room to start to get things accomplished, you know, because it is their job to do so? In case no one has noticed both sides of the aisle have common enemies that everyone should be focused on. Within the healthcare system its chronic disease, preventable and treatable disease, and wildly inflated costs and the business practices of overcharging for products and services simply because it is technically legal. Common sense regulations and limitations on profit, like within the medicare market are not socialist, they are actually quite American.
When did supporting the free-market system become allowing companies to charge obscene amounts of money for products and services at the expense of the American taxpayer simply because they have the consumer by the throat? We can’t reform healthcare and make it more cost efficient by restricting access to it.
Fewer customers mean less competition and if we don’t start listening to the needs of consumers, and start offering a wide variety of products and services that address the needs of everyone, well this really is not going to get any better.
So What Does This Mean For Your Health Insurance Costs For 2017 & 2018
Well, fortunately, as long as the CSR’s continue to be paid, your rates should not increase by more than 15% on a national average. Additionally, regarding the CSR payments, they are not a bailout for the insurance companies. CSR’s and similar measures were necessary for medicare as well initially. Freedom Caucus members, the “burn it to the ground and build from the ashes” Republicans, who would also love to “abolish all taxes” and seem to live in a fantasy land where roads pave themselves and the military funds itself, are responsible for the rhetoric about the CSR’s being a “bailout” for insurance companies.
Regarding a 15% rate increase average estimate, no doubt that is still a lot, and this could be the year in which consumers who are healthy have no choice but to look elsewhere for health insurance or Obamacare alternatives. Even with subsidies, there are millions of families who won’t be able to afford Obamacare plans, also known as “On-Exchange” plans this open-enrollment. While we would prefer that everyone have a simple and easy method to enroll this year, because of the number of carriers who have thrown their hands up in frustration and exited the market, Humana, Aetna, UHC and so on, costs are up dramatically from two years ago.
What might become a common scenario this year, is that within the same household you might see one family member purchasing a plan that is outside of Obamacare, and others purchasing an “on-exchange” Obamacare plan. People will do what they need to in order to survive, that’s also an inherently American trait.
In closing, fear not, we will be here helping guide you through this hot mess that is the American healthcare system, and while we are in fact terribly fed up with just how chaotic and politicized it has all become, it really can only get better from here moving forward. This is rock bottom. It might not feel like it, and you are right to have your doubts, but believe us as the unfiltered unrestrained contrarians within the health insurance industry, we can confidently say that better days are ahead.
Updated September 22, 2017
Republican’s Latest Healthcare Reform Effort is Called the GCHJ Bill – But What Is It?
The Senate is definitely going to vote on the GOP’s latest Obamacare repeal bill next week. The big question is – what is the GCHJ Bill and what is in it? Here’s a quick summary. You can read fore about it here.
Basic Features of the Bill
Instead of subsidies and expanded Medicaid, states would be provided a block grant, a lump sum of money that states could control as they saw fit. These grants could be used to help people enrolled in marketplace plans cover out-of-pocket costs or to set up high-risk pools to encourage them to remain in the marketplace. Healthcare funding could be used in any number of ways by states on an individual level.
Senators Graham and Cassidy say that the block grants would allow states to take control of their unique individual marketplaces, better distribute Medicaid funding and care for truly sick and needy populations. According to information provided by the writers of the bill, New York, California, Massachusetts and Maryland get 37 percent of all federal funding for Medicaid.
Allowing insurance companies to charge more for pre-existing conditions could result in lower rates for healthy people but could make health insurance too expensive for those with pre-existing conditions. States must apply for waivers that allow for the higher premiums and must prove that allowing higher premiums would significantly lower costs to consumers.
In addition, it may be harder for those with pre-existing conditions to get comprehensive coverage. States would be able to require able-bodied Medicaid recipients to work and would also allow people in the marketplace to purchase catastrophic plans. The ACA only allows people under 30 to purchase such plans. The bill also bars healthcare providers that provide abortion services from receiving federal funding, and increases maximums for health savings accounts.
You can get the fuller picture of the bill in this article and check out a pros and cons comparison too here.
Updated August 24, 2017
Zero Bare Counties in the U.S.
For those keeping up on the news about the state of healthcare in America these days, the month of August has basically been a countdown of bare counties across the country. Once a week roughly, CMS would release a map showing the number of carriers in every county in the country, which included the number of counties without any carrier participation.
At the beginning of the summer, the issuer coverage map showed 47 bare counties. By the beginning of July, the number went down to 40 counties but the location of the bare counties changed significantly after Anthem announced that they were pulling out of most of Nevada. This state was later picked up by Centene and on August 23, there was only one remaining bare county in the State of Ohio and that was in Paulding County.
The Department of Insurance in Ohio reported today that CareSource, who was originally an Ohio-based Medicaid insurance provider, has stepped up to sell on exchange plans to the 334 residents of Paulding County, Ohio who currently have coverage. This means that contrary to the concerns of those in the industry and in government, there are no counties in the country without any carrier options this open enrollment period.
The next step for Congress, state insurance commissioners and governors is to find ways to stabilize the market for this season, which starts on November 1st. Passing state and federal legislation intended to stabilize the insurance market ahead of the deadline for carriers to commit to selling on exchange plans, which is now September 27th, will ensure that more carriers either stay in the marketplace or rejoin if they initially bowed out of the season.
Updated August 23, 2017
IRS Reports that Americans Paid Individual Mandate Penalty in 2016 Despite Non-Enforcement
Despite comments after his inauguration that President Trump wouldn’t enforce the individual mandate penalty, the IRS reported recently that 4 million people filed returns claiming that they owed a penalty for being uninsured in 2016. 1.4 million of those returns were filed by individuals, meaning that they voluntarily admitted that they were uninsured despite the fact that the IRS was no longer allowed to reject tax returns that ignore the question of whether a person had compliant health insurance for that year to avoid the penalty.
The average penalty payout from the 2016 tax returns was $708.00 per return.
The number of tax returns filed that admitted to owing the penalty was down from the prior year (5.6 million returns indicated no health coverage in 2015), which may be attributed to the fact that either more people obtained and kept their health insurance coverage in 2016 or people chose to remain silent on that part of the return, which again would not prevent them from submitting their return fully.
The IRS announced on February 15, 2017 that it would not reject silent returns that didn’t check the box to show that their family had health coverage throughout the entire year, or didn’t complete the health coverage exception forms, or didn’t calculate the penalty payment they would owe for not having health coverage throughout the entire year. The IRS states in their report to Congress on the issue that they are reassessing this method and may revert to again reject filings that are silent on this issue.
Also, 3.9 million tax returns claimed that their household was exempt from having insurance under the ACA due to their household income being below the filing threshold and 8 million filed returns claiming that an individual in their household was exempt from getting under the law because they have insurance through their employer or because all of the coverage options were unaffordable or because they meet some other predefined exemption option under the law.
The IRS’ report also states that in 2016, 5.1 million people were eligible for a premium tax credit, which averaged $3,455 per tax return, for a total of $17.6 billion.
Updated August 17, 2017
White House Says That It Will Make the CSR Payments Due for August
The White House announced on Wednesday that the federal government will pay insurance carriers the CSR payments (Cost-Sharing Reduction payments), in August, despite the President threatening to withhold that money, which he labeled a “bailout” to insurance carries.
The Obamacare law promised insurance carriers that the federal government would reimburse them for the amount of discounts that insured Americans received in the form of tax credits if they enrolled in a silver plan and earned between 100% and 250% of the federal poverty level. This money has been withheld for a while now and insurance carriers and the Congressional Budget Office warned that premium prices will go up across the board if this money isn’t received as promised. In total, about $7 billion is owed to insurance carriers to cover these discounts given to Americans.
The Congressional Budget Office (CBO) issued a report on August 15th saying that if the federal government refused to pay out the CSR payments to insurance carriers for the rest of the year that a number of carriers would leave the market, which would result in approximately 5% of Americans having no options for health insurance in 2018. CBO also estimates that premium prices would go up 20% in 2018 across the board because insurance carriers would be required under the law to give these discounts to Americans who buy the silver plan and earn a certain amount of money, but they would not be getting that money back from the government.
Not funding the CSR payments will also have a negative affect on the federal budget because premium costs will rise, which will in turn increase the subsidy amounts people are eligible for and that the government will have to pay.
A number of members of Congress have openly commented that they need to do something soon to ensure that the CSR payments are made to insurance carriers so that the market does not become more unstable in the coming months.
Updated August 14th, 2017
Carriers Given Extension to Submit Insurance Plan Details and Rates
As a way to possible signal to Americans and the healthcare industry that the Trump administration is still hopeful that this year’s open enrollment period can be salvaged, the President and HHS told insurance carriers that they have until September 5th to submit their insurance plan and rate proposals. The original deadline was August 16th. They also have until September 27 to say either way whether they will offer plans on the marketplace this year. Americans can start shopping and enroll on November 1st.
Congress and the President are on vacation and neither the House nor the Senate meet for a session until September 5th, but difference members of Congress have reported that there are people actively working on legislation that will strengthen the insurance market and prompt carriers to offer plans this season, despite the President’s warning that he would rather let Obamacare implode.
One issue that Congress needs to address is whether the administration will pay the cost sharing reduction payments promised in the Obamacare law to carriers to cover the subsidies granted to many families. There is a hefty bill due to carriers for the past couple of years for these subsidy amounts and if they aren’t paid, the cost of premiums this year and in future years will go up significantly, which will make insurance unaffordable for most.
The federal court system is already litigating and ruling for insurance carriers who have brought lawsuits against the government for failing to provide them certain funding promised in the law, and it’s almost certain that many more lawsuits will be filed by carriers if the administration refuses to pay the cost sharing payments.
Updated July 31st, 2017
Consumer Searches for “What Is Obamacare” Are Up 1,400% In The Last Month
In what can only be described as a sort of depressing statistic, HealthNetwork, the parent company of this website, has recently released data that indicates that monthly searches for “What Is Obamacare” are up more than 1,400%.
Not only are searches for this term up dramatically, but the Spanish language searches for the same phrase have also increased as well.
Why should you believe us regarding this data? Well, the main reason to do so would be the reach that HealthNetwork as a company has had with Americans seeking out health insurance options for the last four years. In 2016 HealthNetwork reached more than 18 million American households seeking help with their health insurance options. Only Healthcare.gov reached more health insurance shoppers in 2016.
So Why Does That Matter?
It’s, unfortunately, one indicator that the previous administration didn’t do as effective of a job as they needed to in creating real awareness with all consumers in the United States. It also is not a ringing endorsement for Healthcare.gov, either. When consumers seeking out information on Obamacare are doing so for the first time, they don’t start off by searching for “what is Obamacare”, typically. No, they typically just start off by searching for “Obamacare” or “Obama Care”.
Searches for “what is Obamacare” are up because it’s in the news cycle every day. The scary part of this is that it indicates that there’s a significant amount of Americans, millions, who have yet to do any kind of research on Obamacare.
Creating awareness with consumers, operating in a manner in which you’re embracing outside players in healthcare to help make government-subsidized health insurance approachable, and not so government like, this will help resolve this problem.
As much as we admire what President Obama was trying to accomplish, many of the individuals who ended up getting involved in the process, on a legislative and operational level, focused too much attention on the politics of Obamacare and what it could mean for Democrats and the future of the party.
Obamacare was designed in such a way as to not only be an access and delivery mechanism for “healthcare”, but also as an advertisement for the Democratic party. A number of individuals within CMS, HHS and the team that is and or was responsible for Healthcare.gov, made their focus less about reaching the end goal of enrolling as many Americans as possible in a healthcare plan, and much more about the Affordable Care Act and how it would help swing more voters to the Democrats.
That clearly didn’t work out, as the last two elections are a very clear indication that if you focus on party and not people, it results in too much attention being paid to areas where it isn’t needed. That is precisely when things begin to spiral out of control, and leads to a political backlash from Americans who feel like they’ve been cheated out of something they desperately need.
Just Focus On Fixing Healthcare, Not The Politics, That’s What People Want
If you focus too much on any secondary goal, instead of doing whatever it takes to make healthcare reform work, or put more bluntly, “leveraging political opportunity”, people sense it, and it upsets them, and then they just tune you out until there’s someone they are politically aligned with who is doing the talking. That’s precisely who is searching for “What Is Obamacare” right now, the individuals who tuned out the previous administration. HealthNetwork’s data is also showing more of these type of “what is obamacare” searches in “Red States” than “Blue States”.
Without a true bi-partisan effort being made on Trumpcare, Republicans are destined to repeat the same history of the Democrats. Then we’ll be writing about this same thing in three years, only next time it will be “What Is Trumpcare” that everyone is searching for.
Another Warning For Politicians – Consumers Are Getting More Informed And They’re Asking The Right Questions
Oh, and one other data point regarding consumer search, another term that is relatively new and seeing massive search volume, and should be a concern for anyone in this next mid-term election, searches for “Does Congress have Obamacare” are now one of the 5 most searched terms regarding Obamacare or healthcare reform.
Updated July 28th, 2017
Skinny Repeal of Obamacare Fails – Obamacare Remains In Place For Now
After a stunning blow to Republican-led healthcare reform efforts, the Affordable Care Act remains the law of the land, at least for now. Early morning on Friday, July 28, the Senate voted narrowly against a “skinny repeal” bill that would have eliminated Obamacare’s individual and employer mandates as well as its tax on medical devices. The vote was 51-49 against, with three Republican lawmakers adamantly refusing to support the GOP measure. Sens. John McCain of Arizona, Lisa Murkowski of Alaska and Susan Collins of Maine voted with Democrats to destroy the bill.
The vote came as a surprise to Republican Majority Leader Mitch McConnell, who has spent the last several weeks negotiating and attempting to wheedle support from his colleagues in Congress. As the vote failed last night, McConnell seemed genuinely shocked that his conference couldn’t agree on the measure.
The so-called skinny repeal bill could have spelled disaster for the private insurance market in the short and long term, causing premiums to jump an additional 20 percent next year while reducing the number of the nation’s insured by 15 million people according to the Congressional Budget Office. Those were hard pills for lawmakers to swallow, but no one expected the skinny bill to pass muster. Instead, it was seen as a Trojan Horse tactic to push the legislative process to the next stage.
McCain was outspokenly against this tactic, one that he didn’t trust. Personal meetings and conversations with House Speaker Paul Ryan, Vice President Mike Pence – not to mention a phone call from President Trump himself – would not sway the Arizona senator from standing his ground on the issue of partisan lawmaking. The senator had warned earlier this week that his Congressional colleagues needed to come together on the legislative process.
A long-time opponent of Obamacare, McCain believes that his conservative peers need to take a lesson from history and avoid passing a partisan reform bill. Instead, they need to work with Democrats and pass a healthcare bill that seeks real reform.
For now, the Republican effort at unseating the Affordable Care Act has been thwarted, and there are no current plans to revive the effort in the immediate future. Congress will shift its focus to defense legislation and the nomination for a new FBI director. Obamacare remains the law of the land, which means every American must have ACA-compliant health insurance for the year. The next enrollment period will start on Nov. 1 and end Dec. 15 for the 2018 plan year.
Updated July 26th, 2017 @ 10:15 a.m.
Senate Already Fails to Get Votes to Pass GOP Sponsored Obamacare Replacement Plan
Yesterday afternoon the Senate voted narrowly to begin discussions on healthcare reform and how to repeal and replace Obamacare. The final vote came down to a 50/50 tie, with Vice President Pence casting the tie-breaking “Yea” vote.
Debate and discussion on what the effects of an Obamacare repeal-only plan and the replacement bills from the House and Senate would do to the country took place almost immediate and were expected and did go into the night.
Late yesterday evening, the Senate took up a vote on the BCRA with a few additional amendments, one that would allow insurance carriers to sell plans that didn’t comply with Obamacare (didn’t cover pre-existing conditions) so long as they also sold at least one plan on the marketplace that did cover pre-existing conditions. This amendment was proposed a couple of weeks ago by Senator Ted Cruz. The second amendment added to the BCRA added an additional $100 million in funding to the budget for states to provide relief to people who would lose Medicaid under the roll back provisions of the BCRA. The third set of amendments was proposed by Senate Majority Leader, Mitch McConnell and would remove the individual and employer mandates.
The vote resulted in a 57 “Nay’s” , including 7 from Republicans. The bill needed 60 “Yea’s” to pass.
The Senate will start debate and discussions on the Obamacare repeal-only proposal today, Wednesday July 26th, and a vote on this option is slated for later in the afternoon.
Updated July 25th, 2017 @ 3:04 p.m.
Plan to Discuss Obamacare Repeal Gets Majority Vote
It’s official, Republicans got their 50 votes plus Vice President Mike Pence’s tie-breaking vote, which allowed them to reach the 51 votes required in order to move forward with discussion and debate on how to undo Obamacare and how to replace it – either with Senate’s version of healthcare reform, which was called the BCRA, or the House’s version of Trumpcare, the AHCA, or something in between – the “Skinny Repeal Bill” – which would repeal certain aspects of Obamacare and allow for improvements of other parts.
Debates start this evening.
It remains to be seen if this is the point at which Democrats and Republicans can begin the process to actually work with one another in order to draft legislation that improves on Obamacare, not dismantles it leaving millions without health coverage.
Just today, a video of former House Speaker John Boehner was leaked from a private event in which he says that it is impossible for Republicans to completely remove Obamacare. According to the former speaker, now that Americans truly understand what it is the Affordable Care Act (Obamacare) does, and how it has some significant consumer protections, it is politically impossible to take that away from millions of Americans.
Even more interesting, is that he directly addresses the issues with the more extreme members of the Republican party, by referring to the Freedom Caucus, as the “knucklehead caucus”. According to Former Speaker Boehner, “Now, these are the guys in the Republican party who are – you can call them right of the right. They’re anarchists, they’re for nothing.”
We’d say that accurate description is quite perfect for the Freedom Caucus. Hopefully, this vote starts the wheels in motion that will allow Republicans and Democrats to start behaving like adults and start thinking about people, not “party” first. Healthcare reform that will last, and actually improve lives, will 100% require bi-partisian effort.
Updated July 25th, 2017 @ 2:50 p.m.
Obamacare Repeal-Only Vote Update
No Democrats have voted yet and Senators McCain and Johnson have not voted yet. More updates coming within minutes….
Updated July 25th, 2017 @ 2:40 p.m.
Obamacare Repeal-Only Vote Count Update
48 “Yes” votes and 2 “No” votes.
Susan Collins of Maine and Lisa Murkowski of Alaska are the only “No” votes so far.
Votes are still being whipped so Republicans could still achieve a majority.
Stay tuned for more updates….
Updated July 25th, 2017 2:10 p.m.
Senate to Vote on Obamacare Repeal Today
After President Trump requested that the Senate delay their August break until a vote on healthcare reform happened, Senate Majority Leader, Mitch McConnell announced that he would hold a vote on an Obamacare repeal and roll back on a multi-year timeline would happen today.
For those of you reading this and many other headlines in the news today and wondering whether a vote to repeal Obamacare today means that Obamacare is immediately gone, rest assured that this vote is only to determine whether enough Senators actually want to start discussions and debates on the subject. This is essentially the step that the GOP has been trying to get to regarding the last two attempts at the BCRA too – the “do most of us agree to discuss this issue” step.
No one knows just how the vote will go today. There have been comments made by various Senators (Republican Senators) over the past week or so that they’d be surprised to even get to 50 “yes” votes on the issue of repealing Obamacare without a replacement, and there are some that think that more Republicans will vote “yes” than they are leading on to.
Either way, it’s clear what Senate Majority Leader, Mitch McConnell and President Trump think about the issue – they think that its their duty to constituents to repeal Obamacare and fulfill the promise that the party has made for the last seven years. In fact, President Trump has already sent out several tweets about the issue in the past 24 hours and McConnell published and referenced a statement on his official website.
Congress convenes on the floor at noon and the vote is scheduled to happen a few hours after they convene.
Updated July 21st, 2017
CBO Says Second Try at BCRA is Still Bad – Leaves 22 Million More Uninsured
The Senate published more amendments to their Better Care Reconciliation Act yesterday, July 20th, which included: changes to the age-ratio premium calculation, the benchmark plan percentage to determine tax credits, repealed several taxes imposed by Obamacare including the individual and employer mandates and the small business tax credit, and made changes to Medicaid and HSA’s.
Most interestingly, this amendment removed the Cruz Amendment from the last version, which allowed carriers to offer plans on the marketplace that did not cover pre-existing conditions so long as they offered at least one plan that did.
Other than stripping Ted Cruz of his signature addition, there didn’t seem to be too much else in this version of the BCRA that wasn’t already included in the original version in some form, which may be why the CBO thought that it would do just as poorly at keeping people insured.
One piece that did seem to be more prevalent in this amendment to the BCRA that wasn’t sung as loudly before, was just how much they wanted the states to take responsibility for the insured rates and affordability of insurance for their residents. There were a number of places where the bill stated that it would fund grants to the states to create programs to help stabilize the market and make premiums and out-of-pocket expenses more manageable for residents. They also gave the states a little more leeway on Medicaid eligibility requirements and the age-ratio premium calculations.
Considering the CBO’s score and considering that there’s nothing revolutionary in this amendment that separates it from the first draft, which couldn’t get the votes to move on the first time around, it’s probably pretty safe to say that we’ll see something else from the Senate pretty soon.
To be continued….
Updated July 19, 2017
Obamacare Repeal Now and Replace Later Scored the Worst Plan Yet by CBO
After the amended version of the BCRA failed to get enough votes to proceed forward in the Senate for a second time, the new plan of action was to simply repeal Obamacare now (however the actual effective date of the repeal would be later on) and deal with a replacement plan in the coming months. This plan was called the Obamacare Repeal Reconciliation Act of 2017 and if it has a name, it will be scored by the CBO.
If you recall, the CBO said that the House’s version of healthcare reform – the AHCA – would leave 23 million more Americans uninsured than if Obamacare remained in place. The BCRA, the Senate’s attempt at healthcare reform, faired slightly better and would only leave 22 million more Americans uninsured than if Obamacare remained in place. The CBO announced on July 19th that if we just repealed Obamacare and essentially went back in time to 2009, before the law was passed, 32 million more people would be uninsured by 2026 than if Obamacare remained in place.
The CBO also estimated that by next year, 17 million more people would be uninsured if Obamacare was gone than if it remained in place and that the average premium price would increase by 25 percent by next year as well. By 2020, premiums would be 50% more and by 2026 premium prices would be double what they would be if Obamacare remained in place.
To make matters worse, the CBO believes that carriers would flee from the market by 2020 due to the skyrocketing premiums, which would leave nearly half of the population living in an area with no carrier options.
A number of Senators have gone on the record in the last day or two saying that simply repealing Obamacare now with the hopes and promises that they’ll figure out and pass something better in the future is not the way to go.
It’s pretty safe to say that the Obamacare Repeal Reconciliation Act is more than dead on arrival.
Updated July 18th, 2017
Trumpcare Is Dead For Now – Will President Trump Work With Democrats To Revive It?
It’s un-officially official, Trumpcare is dead in the water for the time being. Or we should say that the BCRA and the AHCA, are dead in the water. Trumpcare might not be dead at all, we simply might be headed for that impossible moment that was so humorously described in Ghostbusters, where cats and dogs are living together, and or Republicans and Democrats agree on something. In all fairness, in Ghostbusters they were describing “the end times” which is not exactly the same thing, but nevertheless we try to inject humor into this otherwise dry subject matter whenever possible.
Democrats And Republicans Have To Work Together In Order To Survive And Fight Other Battles
By that we mean that Republicans and Democrats are actually going to have to work together in order to pass healthcare reform that can actually get passed and survive. It could also be true politically as well. If millions of Americans lose their healthcare, or if premiums continue to go up, there will be consequences for both sides of the isle. While Republicans haven’t extended any invitations to Democrats to join in the process of drafting realistic legislation to repeal and replace Obamacare, Democrats have not been exactly behaving like adults either. Remember when Chuck Schumer took time out from everyone’s busy lives to do a prop joke in front of the press on Capitol Hill?
Nothing motivates President Trump to work with Democrats more than by trying to humiliate him at every opportunity. Oh apparently there’s bonus points if you can do it using his own words, at a juvenile snickering press conference.
We can appreciate that people are frustrated, but we can’t help but point out the obvious that at some point, politicians should reflect for a moment and ask if something like the example above benefits the American people, or is it just wasteful and selfish political theatre.
Until now Republicans have been trying to go it alone, without the help of Democrats. This of course contradicts the campaigning that President Trump did as the ultimate deal maker. According to President Trump, he would be able to quickly get Democrats and Republicans in a room to hash out their differences and bring a bipartisian bill forward to fully Repeal and Replace Obamacare.
During his campaign, repeal and replace was the only option he was willing to accept. Now having gone through the wringer and taken hits from both sides of the isle, he’s changed his tune a bit. That said, based on some of his most recent tweets, we think it is possible he might be ready to start working with Democrats.
Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!
— Donald J. Trump (@realDonaldTrump) July 18, 2017
Freedom Caucus Plays Spoiler In House Bill
President Trump very well have actually wanted to include Democrats from the outset, but behind the scenes it became very clear very quickly, that doing so would not go over well with the Freedom Caucus and their billionaire backers. So the House version of Trumpcare, the AHCA, went through various revisions, including last minute tweaks made by a threatening Freedom Caucus.
They made demands that are politically impossible, and that became very clear when the BCRA, which was much more “generous” than the AHCA, was scored by the CBO, and subsequently the American people. Trumpcare and its various versions, be it the AHCA, BCRA, Ted Cruz’s thing, or Rand Paul’s non-starter idea that require HSA’s and every American to be earning $100,000 a year in order to scale, are wildly unpopular with Americans.
Despite Fears Of Political Backlash From Freedom Caucus – Some Republicans Are Against The BCRA
So now we end up where we are at today. An announcement that regardless of whether or not John Mccain becomes available for a vote or not, there will be no vote because many other Republican Senators are opposed to it.
President Trump sent out a flurry of tweets, one of which seemed to indicate that he might help Obamacare accelerate its pathway to complete implosion. That’s more likely a bluff, only because doing so would most likely doom his future re-election prospects, and seriously place the mid-term elections in 2018 at risk. Democrats will seize on the opportunity to remind every voter that it was more important for Republicans to allow Obamacare to fail, and take millions of Americans health insurance with it, than to just do what politicians used to do years ago, find a way to compromise and agree on a middle ground with one another.
President Trump is a populist, he wants people to be happy with him, he’s got no reason to be fearful of the Freedom Caucus or its backers. They’ve been trying to sabotage him since the election, why would this be any different?
This very well could be the turning point at which President Trump has the same moment of realization as the fictional Mayor of New York in Ghostbusters.
Our guess is that in time, President Trump and Republicans will come to the realization, that it is far more important to save the lives of millions of registered voters.
Updated July 13th, 2017
BCRA Amendments released – but will it bring in more Republican votes?
The Senate released its amendments to the Better Care Reconciliation Act (BCRA) today, July 13th. The proposed revisions are as follows:
- The Cruz-Lee Amendment: Insurance carriers can offer plans on the marketplace that do not comply with Obamacare, meaning they don’t cover the ten essential health benefits or pre-existing conditions and don’t regulate out-of-pocket costs, so long as they also offer a plan on the marketplace that does comply with Obamacare. The government would provide funds to insurance carriers to offset the costs associated with the Obamacare-compliant plans, which would more-than-likely be purchased by a sicker pool of people who need more coverage.
- Medicaid Rollback: There are no substantial changes to Medicaid in the amendment. Medicaid funding would be rolled back starting in 2021 and would be restored to pre-Obamacare era funding and participation by 2024. States could choose whether they receiving funding from the government for Medicaid based on a block-grant or per-capita calculation and could also impose a rule that anyone receiving Medicaid assistance must be employed unless they are pregnant, elderly or disabled.
- Obamacare Taxes: The Obamacare taxes on the country’s wealthiest executives and people will remain in place, which will help the federal deficit.
- Cost-Sharing Reduction Payments: The government will continue to pay insurers the cost-sharing reduction payments through 2020.
- Continuous Coverage Requirement: The amendment gets rid of the individual and employer mandates under Obamacare and imposes a continuous coverage requirement. Under the continuous coverage requirement, if a person goes without health coverage for more than 63 consecutive days, they will be charged an additional 30% a month on their health insurance premiums by the insurance carrier for an entire calendar year. Additionally, the person would be prohibited from getting health insurance coverage for a full six months after reaching the 63-day limit, which would prevent people from only getting coverage because they became sick.
- Out-of-Pocket Costs Assistance: The amount contributed by the government to help offset the out-of-pocket costs of people is increased by $70 billion to $182 billion. This money goes to the states to implement reform efforts, including HSA.
- HSA Reform: Health Savings Accounts (HSA), which is pre-tax money, can be used to pay your health insurance premiums, which was previously prohibited by the rules.
- Opioid Crisis: An additional $45 billion is given to the states to fight the opioid crisis in America.
- Catastrophic Plans: People who enroll in a catastrophic plan can get tax credits to help offset the premium costs. This was previously prohibited by Obamacare.
- Lower Premium Health Insurance Plans: People can enroll in lower-premium health plans that have high deductibles but allow for three visits to your primary care physician a year and limit how much you have to spend a year out-of-pocket and they can get tax credits for those types of plans to make them even more affordable.