Fifty days after the election, proposals of change to the Affordable Care Act have surfaced. In the face of discussion for a “repeal-and-replace” attitude, sweeping change is unlikely given that Republicans lack the 60 Senate votes needed to stop a filibuster.
More likely, adjustments will come gradually through a combination of federal executive, regulatory and legislation actions. At the same time, States may also take legislative action that could affect the shape of the law.
One Notable Option to Head the Department of Health and Human Services
There are still more questions than answers on how Obamacare will look in the future. Here are some updated answers to common questions based on what is known today.
President-elect Donald Trump has selected Tom Price, Representative from Georgia’s 6th congressional district and chair of the House Budget Committee as Secretary of Health and Human Services (HHS). Price, an orthopedic surgeon, is a supporter for physicians and private-sector solutions to health care issues through state regulation. Price has been an active opponent to Obamacare when in 2015 proposed a replacement to the law.
At the same time, Trump has selected Seema Verma to head the Center for Medicare and Medicaid Services. Verma is a health policy specialist who helped shape major reforms to Indiana’s Medicaid program under Governor Mike Pence, now vice-president elect. Under Verma, Indiana’s plan grew eligibility for Medicaid through Obamacare. Verma executed the plan through a waiver program collaborated through HHS that accepted Indiana’s distinctive policy positions; such as requiring small premium payments from some beneficiaries of Medicaid. Trump recently picked Nina Owcharenko of the Heritage Foundation to his Health and Human Services “landing team.” She is immersed in health care policy and recently wrote a paper delivering an outline for repealing and replacing Obamacare by creating a smooth shift to a new marketplace.
One Possible Alternative for the Obamacare Law
The Affordable Care Act mandate has several parts that work in concert. There are three parts of the law that must have the other 2 in place to survive. These three parts are; premium subsides, the individual mandate and the ban on the denial of coverage due to preexisting conditions (known as guaranteed issue). Experts have cautioned that the individual insurance market would be threatened under one conceivable scenario – If the individual mandate and premium subsidies were removed while guaranteed issue is retained.
In the event the individual mandate or premium subsidies are abolished; one idea is to motivate buyers to obtain coverage when they are not immediately in need of health care. This idea is targeted at populating insurance risk pools with reasonably healthy people, thereby stabilizing the market. Republican proposals, including a previous bill called the “Empowering Patients Act” presented in 2015 by Tom Price, prohibited the use of preexisting conditions in coverage and premium determinations for consumers who have sustained continuous health coverage.
The Trump Administration’s Approach to Obamacare
There are more than a few ways a presidency can modify policy or amend existing regulations under Obamacare. For example, government agencies may take an “non-enforce policy” on penalties for breaches of the law, such as the Obamacare penalty fee for individuals who do not have insurance coverage for at least nine-months of the year. The administration could simply revise, replace or withdraw current regulations or rewrite existing ones by providing notice of changes and allowing for public comments.
Private Insurance Approach to Obamacare
At the same time, insurance companies are doing what is necessary to get around the bill by introducing high-end health insurance indemnity plans. These plans are similar-to Medicare, for they have restricted dollar limits on medical spend. The spend limits are measured in valued increments over periods of time such as annual spend and lifetime spend. These plans are less expensive than Obamacare, for they do not have the “ten essential health benefits” and do have restrictions on preexisting conditions. These policies are also subject to the Obamacare penalty fee.
This year In Texas, Insurance4Dallas has introduced indemnity plans that use “Preferred Provider Organizations” also known as PPO networks to give re-pricing on medical facilities and procedures. These plans have been introduced into the Fort Worth Health Insurance market, the Arlington Health Insurance market and the Waco Health Insurance market. These plans are underwritten and often cost less than half the price of Obamacare. In addition, Insurance4Dallas proposes 23 ways to avoid the Obamacare penalty fee outlined by Healthcare.gov.
Here is a Time Line for Change to Obamacare
To make effective changes to Obamacare, there will need to be bipartisan support for a bill. Thus, immediate changes going onto effect during the first six months of a Trump administration are not likely with a Republican held Senate of 52 Senators, will need a 60-vote majority to pass legislation. Changes to the bill will most likely occur three years out to avoid backlash from a midterm 2018 election, where one-third of the Senate is up for re-election.
Insurance4Dallas, (I4D), helps insure all of Texas, Virginia and Florida and provides consumers with detailed information on health insurance with the ability to purchase insurance online. I4D provides a full spectrum of health, dental, vision, life and other ancillary insurance products providing a diverse selection of price and benefit options complemented by personable customer service. Available via phone, email or fax, Insurance4Dallas answers consumer questions throughout the purchasing process and the utilization of their health insurance policies.
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