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What New Government Policies Mean for Your Health Plan

Over the past nine months, the Trump administration has enacted a host of changes across a broad array of topics by using policy changes, executive orders and legislative acts. Included among these changes are a number that apply to health care that could alter how you obtain medical services and how you pay for them. If you aren’t aware of them already, you should familiarize yourself with them so that you are prepared for their impact on you and your family’s health.

Although the Trump administration has been pushing for a repeal of the Affordable Care Act, it has yet to actually pass a legislative package that would scrap Obamacare. Despite several attempts, the Affordable Care Act remains the law of the land, so the new administration is legally required to enforce it. Unfortunately for ACA beneficiaries, President Trump and his Republican colleagues in Congress are committed to dismantling the program; that is why the administration has implemented changes that could kill it.

Shortened Open Enrollment

Last year, the Open Enrollment Period for obtaining Obamacare coverage started Nov. 1 and ended Jan. 31. However, the Trump administration has shortened this to Nov. 1-Dec. 15, or almost half of the original Open Enrollment Period. This is the only time of the year when Americans can enroll in a new health plan or exchange their existing plan without proving a major life change.

In addition to shortening the number of days that enrollment will be available, the administration will also limit the availability of the website on certain days. On every Sunday except one (Dec. 10) during the Open Enrollment Period, the website will be taken offline from midnight until noon for maintenance. More than 36 states use the website as the access portal for their ACA enrollees.

For the almost 12 million Americans who enrolled in an Obamacare health plan in 2017 and wish to re-enroll or switch to another ACA-sponsored plan, these new changes may make it more difficult to do so. Just remember that if you do not enroll in an ACA health plan during this time period, you may not be able to until next year, forcing you to either buy a plan from private insurer or pay the annual penalty for not having health coverage.

Less Assistance

For many people who already have an Obamacare plan or wish to get enrolled, they may miss their opportunity.  Another key policy change that the Trump administration is implementing is a major reduction in promotion and community assistance. The federal government is expected to slash advertising and outreach for Obamacare programs by 90 percent, making the program less visible to many consumers who want to enroll but may not realize the shortened window.

According to one analysis, the 90 percent cut in marketing will cause 1.1 million people to miss the enrollment window.  The analysis suggests that most of this group will likely be younger, healthier enrollees, leaving only a sicker population that will be more expensive to insure.  This will likely add additional pressure on insurers to raise premiums or to exit the health insurance exchanges.

Furthermore, Trump is also cutting funding to many navigator programs that helped educate people about the Affordable Care Act programs and helped them sign up.  The government is cutting the budget for the navigator program from $62 million in 2017 to $36 million next year.  Many of these community-based groups worked year-round to raise awareness and help families without health coverage find a plan that met their needs. In light of the enormous budget cuts, many navigator programs are downsizing operations, while others are shutting their doors.

Cost-sharing Subsidies Halted

One of the most important features of the Affordable Care Act was offering low-cost health plans through participating, private insurers.  In order to make these plans available, the government promised to compensate insurers for losses through cost-sharing subsidies. In 2017, the government paid out $7 billion to insurers who offered discounted health plans on the health insurance marketplaces.

Cost-sharing subsidies compensate insurers for discounts they legally obligated to offer.  These discounts on deductibles and other out-of-pocket expenses on low-cost plans will remain in place even without the government subsidies, but insurers are likely to raise premiums on health insurance policies on the exchanges—or stop participating in the exchanges entirely.

However, for most people who have an Obamacare plan and get a tax credit to help pay for the premiums, they shouldn’t see an increase in the amount they pay monthly.  That is because the Affordable Care Act mandates the government increase the assistance for these plans if premiums rise. Unfortunately, the people who will be most hurt by the halt in insurer subsidy payments are those who pay premiums for ACA-sponsored plans entirely on their own.

Affordable Care Act
Michail Petrov/

New Plan Offerings

In October, President Trump signed an executive order that would allow insurers to sell health plans at lower cost but with fewer benefits than those required under the Affordable Care Act.  The key market for these new policies would be younger, healthier Americans.  While this would likely be advantageous for this demographic of young, healthy, middle to higher income Americans, it will hurt the rest of the population.

New Government Policies Mean for Your Health Plan

Without the financial input from healthier, less costly beneficiaries, the Obamacare insurance pool will become more expensive to cover. Once again, the only alternatives for private insurers will be to raise premiums to compensate for the additional costs, or to leave the Obamacare exchanges.

There is a fairly consistent philosophical backing to the many changes that the Trump administration has enacted regarding health care: Obamacare has unfairly placed the financial burden of insuring sick Americans on younger or wealthier people, and should be reversed.  The result of failing to legislatively roll back the Affordable Care Act is that the administration is taking it upon itself to dismantle the law in a number of smaller, more incremental steps.

If you would like to enroll in an ACA health plan for 2018, please visit Boost Health Insurance.

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