Whether you already have health insurance or not, you’re probably wondering if you still need coverage now that Trump has proposed repealing and replacing the Affordable Care Act (ACA). What you do in 2017 will affect what happens to your chances of continuing coverage going into 2018 and beyond.
Marketplace open enrollment ends for 2017 on January 31, except for people who meet the conditions for a special enrollment period. Losing your job, having or adopting a child, getting married, or facing financial hardship are just some of the reasons why someone might meet a special sign-up period. If you qualify for Medicaid or CHIP, you can enroll at any point in the year.
For those who sign up in 2017, coverage should continue without interruption since it will take some time for Republican policies to pass through the government lawmaking process. Your policy can’t be canceled and the insurance company can’t raise the price during the year.
More than 8.8 million people have taken the advice to enroll, increasing health plan purchases by 100,000 more than last year at this time. In addition, over 40,000 people have contacted the marketplace with questions about signing up.
What We Know Already
If you are already enrolled, you will have a better chance of staying enrolled through the transition without incurring additional expenses for health conditions or age limitations due to a lapse in coverage. Since Republicans plan to bring back high-risk pools, anyone going without insurance can end up paying higher premiums if circumstances change before re-enrolling in a health plan.
Automatic enrollment in high-deductible Health Savings Accounts (HSA) could take place anytime between 2018 and 2019, but you will be able to opt out without a tax penalty. Trump’s timeline is unclear because most of what he wants to do will require an act of Congress. However, Republican lawmakers in the House and Senate agree to repeal and replace Obamacare. How to implement the changes, while keeping certain provisions in place like pre-existing conditions and coverage for those between the ages of 18 and 26, along with other details, have yet to be hammered out.
The Department of Health and Human Services (HHS) will come into play by possibly redefining what types of services are considered to be preventive care in 2018 and withholding funding from places that provide it, such as Planned Parenthood. Trump has nominated Tom Price to be the new head of HHS, who is anxiously awaiting confirmation by a Senate vote for the appointment. After that, some decisions may become final with passage of the Patient Freedom Act recently introduced by Republican senators. Trump has made it clear that some health coverage areas, like preventative care and abortion services, may disappear. Trump has asked the HHS to stop running enrollment advertisements and you may have noticed the uptick in email notifications from the marketplace as a result.
In 2018, major changes give states up to two years to implement replacement plans that could begin randomly. In the meantime, they are allowed to “waive, defer and grant exemptions” for parts of the law that they feel unnecessarily burden families, health care providers, pharmaceutical manufacturers and medical facilities. They may look to state governments like Massachusetts that have been offering universal access, similar to federal ACA law, for ideas on how to follow their lead and replace coverage through state systems. They may set up insurance exchanges and expand Medicaid programs on their own depending on the proposed block-grant funding for Medicaid, since federal funding for state Medicaid programs will no longer be open-ended. An annual set amount must cover the cost of these programs and those figures have not been clarified.
Other Considerations for Continued Enrollment
Although premiums have risen again this year and high-deductible health plans require you to spend a significant amount before coverage begins, about 85 percent of consumers will qualify for tax credits that reduce out-of-pocket expenses significantly. Trump has not provided information on his intent to offer similar assistance or whether his tax proposals would take the place of these subsidies. While these credits are still available, you need to take advantage of them now.
Would Trump really want to take insurance coverage away from 11 million people, and put a financial hardship on another 9 million receiving subsidies, by repealing a law without providing a viable replacement? That is highly unlikely. He will continue to talk to lawmakers and find a way to continue coverage for those who currently have it by offering individual HSA products, making much needed changes to Medicare and Medicaid program funding, reducing federal regulations while increasing state government involvement in the process, and rewarding those that stay insured by allowing them to keep coverage without being subjected to high-risk pools with increased premiums.
Enrolling in the current ACA health plans through insurance marketplaces is still the best option faced with our current situation. By signing up for health insurance now, you’ll make it easier on yourself to maintain continuous coverage and get better rates in the future, regardless of which Republican plan makes its way through Congress.