As the nation enters into a transitionary period with a new administration, many people are wondering how their health insurance may be impacted if they are enrolled through the Affordable Care Act. As we have received this question many times over the last few weeks, we thought we would share the thoughts from HPM's Health Benefits Consultant, Tom Hutton.
Is Obamacare Going Away?
The short answer is not this year. However, we should expect changes to come but no sooner than 2018. There are currently 20 million people today who have obtained insurance under the Affordable Care Act (ACA). President-elect Trump has endorsed the following changes to the ACA:
- Allow individuals to fully deduct health insurance premiums
- Allow insurance plans to be sold across state lines to increase competition
- Expanding access to health savings accounts that are tax free
- Eliminate the mandate to have health insurance
The following are the components President-elect Trump has indicated he wants to keep:
- Allow children to stay on parent's policy until the age of 26.
- Eliminate waiting periods for pre-existing conditions.
Can I Still Buy Health Insurance through the ACA?
Yes, you currently can but typically just through the open enrollment date.
When is Open Enrollment?
Open enrollment was November 1st 2016 and ends January 31st 2017. The deadline is the 15th of the month for your coverage to begin the 1st of the following month. All applications submitted after January 15th will have an effective date of March 1st, 2017.
Can I Join a Plan Outside Open Enrollment?
Yes- but only if you qualify for a Special Enrollment Period (SEP). You qualify for a SEP if you have had a certain life event, including losing health coverage, moving, getting married, having a baby or adopting a child. If you qualify, you usually have 60 days following the event to enroll in a plan.
What are the Essential Health Benefits that All Plans Must Currently Cover in the Marketplace?
- Outpatient care services
- Emergency services
- Pregnancy, maternity, and newborn care
- Mental health and substance abuse
- Prescription drugs
- Rehabilitation and substance use disorder services
- Laboratory services
- Preventative and wellness services
- Pediatric services, including oral and vision care
What if I Can Not Afford to Buy a Health Insurance Plan Through the ACA?
You can earn a subsidy if you earn 400% or less of the Federal Poverty Level (FPL). For example, a family of four can have an aggregate gross income up to $97,000 qualify for a subsidy. The following link is an on-line tool to check your eligibility:
Neither the politicians nor the professionals at HPM Insurance can predict what the future holds for the ACA, but rest assured that we will certainly keep on top of the issues and be a trusted resource for information.
Please note that the information regarding the ACA is subject to change. The intent of this blog was to provide a snapshot of information based on what is currently known as of January 9, 2017. This material is for informational purposes only. All statements herein are subject to the provision, exclusions and conditions of the applicable policy, state and federal laws. For an actual description of all coverages, terms and conditions, please refer to the applicable insurance policy.