We are getting a lot of questions about the end of Obamacare and “when will my premiums go down?” There have been many changes to our individual and small group health insurance plans over the past five years. The Trump administration has spoken loud and clear that they want to do away with Obamacare, we can already see it won’t be quite that easy. We do expect several changes over the next 12 months but overall we think many of the current provisions will continue.
Trumps healthcare agenda
We don’t expect a full repeal of Obamacare but there are a number of changes we think will happen over the coming year.
- Allowing carriers to sell insurance across state lines
- Association health plans and an expansion of self-insured small group plans
- Delay the Cadillac Tax until 2026
- Eliminate employer shared responsibility penalties
- Allow individuals to use subsidy dollars for any health plan
- Increase HSA contributions to nearly double the current limits
What won’t change even if Trump gets his way?
- Pre-existing condition exclusion
- Ability to cover children to age 26
- Preventive services covered at 100%
- No annual or lifetime limits
- Limits on out of pocket maximums for large claims
There are also a few things that could go either way
- Limiting the pre-tax treatment of employee deductions for medical and dental plans
- Allowing tax deductions for individual policies
- Allowing employers to pay for individual policies with deductible dollars
- Allowing states to made decisions about Essential Health Benefits
You can see, there are a lot of moving parts and with every change there are winners and losers. What we do know is right now is it’s business as usual and you must continue to comply with the current rules. Carriers are making decisions right now about what types of policies they will offer in 2018 and who they will offer them to. Without a clear direction from the current administration we fear most will find it easier to walk away than continue to lose money in the individual market.
It’s important to understand that most of the pain is in the individual market. This is where the huge premium and benefit subsidies are being paid and the lack of enrollment, eligibility and guarantee issues rules have made it all but impossible for insurance carriers to manage claims and losses. Here in Tennessee we have been BlueCross BlueShield of TN pull out of the large markets leaving in many cases just one carrier for people to choose from. As of today, Knoxville and the surrounding counties will not have any insurance companies to choose from leaving them unable to get any coverage at all. Hopefully another carrier will fill the void but at what cost?