Our 2018 - 2019 Guide To Safely Enrolling In Obamacare
It isn’t often that we get to kick off our Annual Obamacare Open-Enrollment announcements with some good news, but that’s precisely what is occurring today. So first and foremost, without question the best news we have to share, is that Obamacare plans are declining in price in some states for the first time ever. Even in states where rates are not declining, the states that have an average increase, it is relatively modest. On a national level, there’s about a 5% increase in average premiums. While we do agree that 5% is in fact additional cost, it pales in comparison to some of the increases of the past, which on a national level exceeded 25% in some years.
Below we break out all of the different rate increases and decreases on a state by state basis. You will notice two different sets of percentages per state. One rate is reflective of CSR (cost-sharing reduction) payments being made to the government by the Trump Administration, and one rate without. It is unlikely that the CSR payments will be made, just like they were not paid last year.
Before you focus entirely on the rate chart, we wanted to take a moment and issue a serious consumer warning regarding some negatives about this coming open-enrollment. We strongly advise you to read this entire update, as it could help you avoid some serious headaches when it comes time for you to shop your options and see what plans are available.
Obamacare Rate Changes By State For 2019
|STATE||Approved Rate Change For 2019 With CSR Payments||Approved Rate Change For 2019 Without CSR Payments|
|Alabama (AL) 2019 Obamacare Rates||-16.41%||-2.01%|
|Alaska (AK) 2019 Obamacare Rates||-9.60%||-3.90%|
|Arizona (AZ) 2019 Obamacare Rates||-18.97%||-5.27%|
|Arkansas (AR) 2019 Obamacare Rates||-7.96%||4.54%|
|California (CA) 2019 Obamacare Rates||5.20%||8.70%|
|Colorado (CO) 2019 Obamacare Rates||-5.10%||5.94%|
|Connecticut (CT) 2019 Obamacare Rates||7.43%||12.30%|
|Delaware (DE) 2019 Obamacare Rates||-7.00%||3.00%|
|District of Columbia (DC) 2019 Obamacare Rates||6.42%||15.52%|
|Florida (FL) 2019 Obamacare Rates||-2.50%||8.80%|
|Georgia (GA) 2019 Obamacare Rates||-5.82%||6.14%|
|Hawaii (HI) 2019 Obamacare Rates||3.82%||13.82%|
|Idaho (ID) 2019 Obamacare Rates||-2.78%||8.00%|
|Illinois (IL) 2019 Obamacare Rates||-12.18%||0.72%|
|Indiana (IN) 2019 Obamacare Rates||-7.90%||5.10%|
|Iowa (IA) 2019 Obamacare Rates||-5.00%||3.00%|
|Kansas (KS) 2019 Obamacare Rates||-3.49%||6.11%|
|Kentucky (KY) 2019 Obamacare Rates||-0.35%||12.15%|
|Louisiana (LA) 2019 Obamacare Rates||-15.70%||-6.40%|
|Maine (ME) 2019 Obamacare Rates||-8.99%||1.01%|
|Maryland (MD) 2019 Obamacare Rates||-6.56%||0.55%|
|Massachusetts (MA) 2019 Obamacare Rates||4.12%||4.12%|
|Michigan (MI) 2019 Obamacare Rates||-3.44%||1.69%|
|Minnesota (MN) 2019 Obamacare Rates||-15.40%||-8.00%|
|Mississippi (MS) 2019 Obamacare Rates||-9.85%||0.15%|
|Missouri (MO) 2019 Obamacare Rates||-10.32%||1.88%|
|Montana (MT) 2019 Obamacare Rates||-3.90%||6.00%|
|Nebraska (NE) 2019 Obamacare Rates||-12.60%||1.00%|
|Nevada (NV) 2019 Obamacare Rates||-7.70%||2.30%|
|New Hampshire (NH) 2019 Obamacare Rates||-26.33%||-13.47%|
|New Jersey (NJ) 2019 Obamacare Rates||-9.20%||-9.20%|
|New Mexico (NM) 2019 Obamacare Rates||4.02%||10.02%|
|New York (NY) 2019 Obamacare Rates||8.60%||8.60%|
|North Carolina (NC) 2019 Obamacare Rates||-8.10%||-4.10%|
|North Dakota (ND) 2019 Obamacare Rates||-15.38%||7.42%|
|Ohio (OH) 2019 Obamacare Rates||-4.90%||6.30%|
|Oklahoma (OK) 2019 Obamacare Rates||-14.31%||-1.91%|
|Oregon (OR) 2019 Obamacare Rates||1.20%||7.30%|
|Pennsylvania (PA) 2019 Obamacare Rates||-5.52%||0.70%|
|Rhode Island (RI) 2019 Obamacare Rates||8.86%||9.66%|
|South Carolina (SC) 2019 Obamacare Rates||-2.28%||9.22%|
|South Dakota (SD) 2019 Obamacare Rates||-10.86%||3.54%|
|Tennessee (TN) 2019 Obamacare Rates||-22.79%||-10.79%|
|Texas (TX) 2019 Obamacare Rates||-10.61%||1.52%%|
|Utah (UT) 2019 Obamacare Rates||-14.00%||0.49%|
|Vermont (VT) 2019 Obamacare Rates||1.65%||6.06%|
|Virginia (VA) 2019 Obamacare Rates||-2.70%||11.34%|
|Washington (WA) 2019 Obamacare Rates||5.08%||19.08%|
|West Virginia (WV) 2019 Obamacare Rates||1.55%||14.85%|
|Wisconsin (WI) 2019 Obamacare Rates||-16.50%||-3.50%|
|Wyoming (WY) 2019 Obamacare Rates||-12.65%||-0.25%|
There have been two key things that have occurred that will have a material impact on this open-enrollment for the 2018 and 2019 OEP.
Short term health insurance has been deregulated, which in our opinion, is better than how it was set previously. Under the new regulations, consumers can now sign up for a short term health plan for up to twelve months, instead of being limited to three months. We think that long term, that is better compared to limiting these plans to three months. Now here’s the downside of this deregulation it encourages the shady operators and companies in the health insurance industry to use misleading practices, or outright false information in their marketing materials. They will often try to steer you towards some kind of alternative plan, from a company you have never heard of. Some sites will make it seem as if they are associated with a government entity, and also require you to disclose any pre-existing conditions that you might have, simply before giving you a health insurance rate quote. Don’t be fooled. HealthNetwork has never required consumers to disclose if they have a pre-existing condition. We do not require that information in order to provide you with accurate rates. The only time you should be required to disclose if you have a pre-existing condition, is on your actual short term insurance application.
The other issue, is that most of these companies will often collect your information, and then immediately resell it to a third party, who then does the same thing. Then your phone starts ringing, and ringing, and ringing, for what can sometimes be, days on end. We do not do that. Our goal is to provide consumers with factual information and access to reputable, licensed, health insurance professionals. These are highly vetted companies that have too much to lose by using slimy business practices.
So What Does This Mean For Enrolling In An Obamacare Plan?
What this means, is that it is now even more critical that you be extremely discerning with respect to who you interact with online, or over the phone. At HealthNetwork, parent company of this website, we have made a very clear distinction as to whom it is that we feel is best serving consumers with regard to short term health insurance. Those companies are National General, and United Healthcare. They are both multi-billion corporations, and frankly speaking, when it comes to health insurance that isn’t as tightly regulated as ACA plans are, which short term health insurance is not, we feel that it is best to go with a well established company. United Healthcare Short Term Health Insurance, and National General Short Term Health Insurance, are, in our opinion, the best options for an alternative to Obamacare.
Why Should You Trust What We Have To Say?
For one, we are very transparent as a company and as an organization. We don’t hide who we are, nor do we make it difficult to get in contact with us. We are also very clear about our business practices, and that we DO NOT resell consumer data and create that toxic experience where you phone rings non-stop. We choose to place the consumer experience above everything else, and the end result, is that we have become a company that more than 15 million consumers rely on annually for help regarding their health insurance. A lot of this is from word of mouth referrals. For nearly six years, essentially as long as Obamacare has been around, we have been providing consumers with a safe and secure way to research their options under Obamacare. Now, with the expansion of short term health insurance, we felt it was imperative that we provide factual information on short term health insurance, and highlight in detail, all of it's positives, and negatives.
Having this consumer focused approach is why this website, and our parent company, HealthNetwork, have been featured on some of the following national news sites as a helpful resource regarding information regarding Obamacare and health insurance in general.
- Huffington Post
- National Review
- The Boston Globe
Something Else That Is Extremely Important About This Open Enrollment For 2018 and 2019
Rates have declined in many states, and others they have not, but one additional thing that has occurred that is actually a positive, is that there are now more insurance carriers participating within the marketplace that last year. While some carriers are still not participating with the on-exchange (Obamacare) segment of the business, some, for example, Oscar Health Insurance, are actually jumping into new markets. Any time there are more companies participating within a market, that means (typically) more competitive pricing and benefits for consumers.
Either way, there are now more legitimate reasons why consumers should be seeking out pricing information and plan comparisons. Again, we advise that you do so carefully. For some individuals and families, they may qualify for an Obamacare plan at little to no cost, thanks to subsidies provided by the Affordable Care Act, aka, Obamacare. How much cheaper your insurance is, depends entirely on how much money your household makes, and the total number of individuals within the household. The state and more importantly county, that you are located in, also makes a difference as well. The point of telling you this is for the following reason. It IS CRITICAL that your household eligibility information be 100% ACCURATE and updated for the 2018 - 2019 season. If we have outdated information regarding your income and household, then we can not provide you with accurate information on what the final cost will be when subsidies are factored in. When open-enrollment kicks off, we will send you an email with a link to where you will be able to go to see what your options are, based on the submitted household data. As long as your profile has been updated for 2018, then you will be able to compare accurate health insurance rates, for all available health insurance carriers.
You can use the form below to update your household census information for the 2018 - 2019 open-enrollment season.
Again, at HealthNetwork, we are, and always will be a consumer focused entity who strives to go above and beyond in our effort to make obtaining health insurance, not be so darn difficult. It doesn’t have to be, and we’re doing everything we can to be as helpful as possible. Helping you before we help ourselves has always been our #1 priority.
Why? Because People Matter.
Previous Updates Prior to 9/4/2018 Listed Below
The 2019 Open Enrollment Period is Right Around the Corner and With the Expansion in the Short Term Health Insurance Rules, You'll Have More Options Than Ever!
HHS announced on Wednesday, August 1st that it was reversing the 2016 rule that limited all short term health insurance plans to three-month terms.
The new rule:
- Allows for people to have a short term health insurance plan for 364 day-terms
- Allows for people to renew their short term health insurance plan for 2 years, or a total coverage period of 3 years (36 months)
- Consumers can start to buy these 364-day short term plans on October 1, 2018.
Short term health insurance is a health plan that acts a lot like major medical plans (Obamacare plans), but it typically does not cover pre-existing conditions or pregnancy. These plans are oftentimes half of the cost of an Obamacare plan and they can start next day. There's also no enrollment period and you can cancel at any time.
Despite the fact that these plans did not qualify as compliant coverage under Obamacare, which means that people with short term health insurance plans would be penalized under the individual mandate, these plans were still a great fit for some people. But, after a ruling by the Obamacare administration in 2016 limited their term to only three-months, many people found the plans to be unhelpful. The biggest issue with the three-month term limit was the fact that the deductible requirements would start back over again at the end of every term. Some carriers found ways around that if a person was signing up for a consecutive term, but it was still less coverage than you would get under Obamacare.
Short term health plans made a bit of a come-back and their attractiveness increased in 2017 and 2018 when their low prices outweighed any of the negatives when compared to the high prices of Obamacare plans, particularly for people who were not eligible for sufficient subsidies.
The 2019 Open Enrollment Period starts on November 1st. People will be able to start buying these new, longer duration short term health insurance plans on October 1st, which means that when consumers are weighing their options for health insurance in 2019, they will not only have Obamacare plans to consider, but also short term plans.
For the 2019 calendar year, it doesn't matter whether a consumer picks an Obamacare plan or a short term plan because there's no individual mandate penalty for being uninsured or having insurance that doesn't meet the requirements of the Obamacare law starting on January 1st, 2019.
Open Enrollment For Obamacare Has Ended - What To Do If You Didn't Sign Up In Time
Friday, December 15th was the last day of the 2018 Open Enrollment Period. If you didn’t get health insurance coverage but still want it, you’ll need to check out an Obamacare alternative called Short Term Health Insurance.
Otherwise, if you wish to enroll in an Obamacare plan after December 15th, you are required to have what is called a qualifying life event (QLE). This is a life event that allows you to sign up for health insurance (Obamacare) outside of open-enrollment. In previous years, often individuals would end up finding a health insurance broker to help them find a way around this regulation. Within the last 12 months, however, CMS has cracked down on these practices, because often individuals would simply wait until they needed some kind of medical care or a procedure, and then sign up, and then stop paying for their coverage when they no longer needed it. These type of practices make health insurance costs incredibly high for everyone else who is doing the right thing and keeping their coverage year round, which is why CMS is taking such a hard line on this issue.
If you missed open-enrollment through no fault of your own, you may have the ability to get an exemption that allows you to still sign up. If you don't, however, qualify for an exemption, a short-term health insurance plan, or better yet, a bundled plan that combines short term with some other benefits, really is going to be your best option. That said, the industry is littered with some very crappy plans being marketed in ways that we do not agree with. Below we will explain what we feel is the best approach when it comes to exploring alternatives to Obamacare.
Pros And Cons Of Short Term Health Insurance - How To Get The Best Coverage Possible In 2018
Pros of Short Term Health Plans - And Obamacare Alternatives
- Lower Premium Costs: Short term health insurance plans, and or supplemental insurance plans and bundles, can often offer excellent coverage at half the cost of an Obamacare plan. This is particularly true for anyone who doesn’t receive a substantial subsidy.
- Access To Doctors And Hospitals: Now this is one area where you have to be careful about reading the fine print, thankfully, we’re doing a lot of that for you, by helping you bypass the plans that are not worth considering. Of the short-term-health-insurance plans, or Obamacare alternative plans, that from great insurance carriers, the level of coverage and access to doctors and hospitals that they provide, is excellent. Just note, that it is really important that you (in our opinion) only go with a plan from a large well-established provider. There a lot of smaller short-term plans hitting the market, and a few have come and gone already. That’s why we feel it is best to go with a short term health plan, or bundle, from a large national insurance carrier, whom you can have confidence is going to remain in business indefinitely.
- Out of Pocket Costs: A lot of these plans, particularly, health insurance bundles, which are often short term health plans combined with additional coverage policies that help pay for out of pocket expenses, will result in much lower overall costs compared to ACA plans, which are often complained about as having out-of-pocket expenses that make the coverage too expensive to use.
Cons of Short Term Health Plans - And Obamacare Alternatives
- No Coverage For Pre-Existing Conditions: Plans that are alternatives to Obamacare, almost never provide coverage for any serious pre-existing condition. So if you have serious health problems, or even ones that are not life-threatening now, but could be later, like diabetes, one of these alternatives is most likely not going to be a fit for you. That said, it doesn’t hurt to have a conversation with a licensed health insurance professional, because some conditions will be covered and some will not. We feel the best thing to do, is to connect with a company who can help you enroll in both types of plans, an ACA plan, as well as an alternative. We can help you connect with a company who can provide precisely this level of service.
- ACA Alternative Plans Do Not Cover Pregnancy: So if you are expecting, or planning on expecting, you should consider exploring a plan through the ACA, or a group health insurance plan that does cover pregnancy.
- Crappy Plans With Limited Benefits: There’s a lot of junk coverage hitting the market from companies that to be totally candid, we just don’t understand how their executives sleep at night. Plans that are marketed under familiar names, but with benefits that really aren’t going to help anyone in reality, certainly in a medical emergency. We can’t name-names, but what we can do is give you an example of one such plan that is marketed as an alternative to Obamacare, where it is hard to determine where the value is. If a plan that costs $200 a month, but offers a maximum of $200 a day if you are hospitalized, up to a maximum of 20 or 30 days. That’s a plan with questionable value. Why? Well if you are hospitalized at all, your daily out of pocket costs will be in the thousands, not the hundreds. Unless that plan comes along with a time machine to take you back to 1905, $200 a day doesn’t get you much coverage in a hospital. So it is very much buyer beware, and again, we will repeat this often, if we had to make this decision for ourselves, we would be going with a large national brand, with a wide range of coverage and benefits.
In previous years, short term health insurance was not a good option for people who were concerned about the individual mandate because short term plans do not comply with the Affordable Care Act, which means that you would be penalized if you had one instead of an Obamacare plan. However, Congress repealed the individual mandate requirement in their tax bill, which was signed into law by President Trump on December 22nd, so this means you can get any type of health insurance plan that you want without fear of being taxed for not complying with the Affordable Care Act.
Short term medical insurance is an interesting health insurance option for a lot of families because it is more affordable than a regular, major medical plan. Short term medical insurance has the same, up front benefits that a regular, major medical plan (Obamacare plan) has, meaning that you can go to the doctor and present your insurance card to the medical provider and your plan will cover the portion of the medical expense that it is responsible for and you will pay the rest in the form of a deductible or copay or coinsurance, similar to major medical plans.
If you need prescription drug coverage, that is available in some short term health insurance plans as well.
It’s important to make sure that you’re insured at the end of the day. Facing a medical emergency without any kind of health coverage could be devastating to your bank account and your ability to get access to the healthcare you need to get better quickly.
Everything You Need To Know About Obamacare’s Open-Enrollment (And How To Avoid Having A Horrible Experience Trying To Get Healthcare)
As if healthcare were not already complicated enough, we at HealthNetwork (the company responsible for publishing the guide to Obamacare enrollment and other information on this website) just can not imagine a way in which this enrollment year could be any more complicated than it already is. First of all, let’s start off by disclosing that we’re most likely in the exact same situation that you are, so we feel your pain.
HealthNetwork was founded because the team of dedicated individuals working within it saw a real need for a company to exist in healthcare that could help consumers in ways that the government exchanges and existing insurance brokers could not. HealthNetwork is unique in that we are neither an insurance broker nor a lead generation company. Instead, our mission has been to help consumers avoid some of the common pitfalls that can await them when it comes time to enroll in a health insurance plan.
What are some of those pitfalls? Well, we want to keep this brief, but here’s a list of some of the areas where consumers can run into an issue.
How Does HealthNetwork Make Healthcare Less Of A Headache?
Not every insurance broker, or insurance carrier for that matter, has the consumer’s best interest at heart. At HealthNetwork, we only work with highly reputable companies. We work with companies who frankly have too much to lose if they were to operate in an unethical manner. We require that these companies comply with the standards that we set, which are put in place to protect the consumer experience and if our partner companies do not comply with these standards, we terminate the relationship and stop working with them.
Lead generation companies, which operate websites that often lead you to believe that you are going to receive pricing information or quotes after you provide them with your personal information, just end up reselling that data to whoever is willing to purchase it. That’s when your phone starts ringing off the hook multiple times a day for weeks on end. It’s a terrible experience that we actually know for certain places peoples lives at risk when it’s done in the healthcare space. We feel so strongly about it that we spent $100,000 producing a viral video explaining why we’re different and why “lead generation” sucks for the consumer. Here's a link to the most honest commercial ever about Lead Gen.
Government can be great, but they often miss the mark when trying to execute on highly complicated initiatives like healthcare reform. It doesn’t matter who is running the government, all sides of the aisle routinely shoot themselves in the foot when it comes to healthcare reform. Part of the problem with the state exchanges, as well as the federal exchange, is that they are not really realistic about just how complicated health insurance or healthcare is. It is ridiculously complicated, and consumers are often going to need more than just a website with data in order to make the right decision.
Healthcare.gov and state exchanges do not employ licensed insurance agents to answer the phones and answer questions. So the end result is that the phone support provided by exchanges is turned over to individuals who certainly are trying to be helpful, but legally, cannot advise consumers on what plan might be best for them based on their specific circumstances.
Additionally, depending on the circumstances, in some states you can actually pay less for an off exchange health insurance plan (no subsidies) if you go through a broker or direct to the insurance carrier, and not one of the exchanges because brokers and carriers may have access to more plans than are offered on Healthcare.gov.
Also, we will update you very soon with more information on an interesting circumstance that many more people will face this open enrollment period where, due to some bizarre circumstances driven by politics, there will be more policies available to people for absolutely zero cost per month.
We are always practical and pragmatic, and we ignore the politics surrounding healthcare reform. While we might report on it and comment on it, we are not taking a side in the healthcare debate. As such, we do not believe that we should automatically reject a health insurance plan that does not comply with the standards set by the Affordable Care Act (Obamacare).
We recognize and understand that not everyone can afford an on-exchange Obamacare plan or an off-exchange plan (major medical plan). There are a number of “Obamacare alternatives” or alternatives to major medical health insurance, out there this year and some of them are really great and some of them are complete garbage. Our goal is to help you educate yourself on how to understand the difference and not get duped into buying something that is not a quality insurance product.
Because of everything mentioned above, we felt that there needed to be a company like HealthNetwork to take a practical approach to helping consumers make the best of how difficult healthcare is. So what does that mean exactly?
If you are researching Obamacare health insurance or one of the Obamacare alternative plans, it is probably because you work for a company who doesn’t provide health insurance coverage or you are self-employed or you are currently not working. So the following reasons are all of the different ways in which HealthNetwork and this website, Obamacare.net, can help you this open enrollment period, and frankly year-round.
- Research And Enroll In An On-Exchange or Off-Exchange Major Medical Insurance Plan Through An Online Broker
- Research And Enroll In A More Affordable Alternative Plan To Obamacare or Major Medical Insurance
- Purchase A Health Insurance Plan Direct From An Insurance Carrier
- Speak With A Licensed Health Insurance Agent That Can Have A Detailed Conversation About Your Specific Needs
- Gain Access To Certain Benefits Like Discounted Telemedicine Services, Urgent Care Services, and Prescription Discounts
Some important disclosures, we are in fact a for-profit business. We do get compensated by some, but not all of the entities that we direct consumers to. That said, since our company was founded in 2013, we have sacrificed tens of millions of dollars in revenue by doing right by the consumer and trying our best to treat the consumer exactly how we would want to be treated. That’s not an exaggeration, it’s just a fact. If we didn’t care about people, we would would not put things in place like the HealthNetwork Gives Back Program.
Our focus is to always be a sort of Swiss Army Knife for healthcare, helping you deal with whatever problem or challenge you might be facing from moment to moment. We choose not to be a licensed broker because we feel it removes a potential conflict of interest. Additionally, not being licensed gives us more freedom to be completely candid with consumers and to tell people exactly how it is.
As we get closer to November 1st, when Open-Enrollment officially kicks off, we will have a detailed update on what we’re advising consumers to do with respect to their healthcare options this year.
President Trump Signs Executive Order For Health Insurance Reform Updated October 12, 2017
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.
President Trump Expected To Sign Executive Order On Healthcare Thursday Updated October 11, 2017
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.