Changes are Coming to the Affordable Care Act (ACA) – What is at Stake?

poppy the cockatooPoppy the Cockatoo tweets about the ACA :  “I’m hiding here because the feathers are going to hit the fan.”

When the Affordable Care Act was enacted, its purpose was to:

  • Improve affordability and accessibility
  • Oversee, coordinate, and govern the many pieces in play

It did, and it didn’t.  What it did do was:

  • Stretch across both the private and public payor structure
  • Add more Americans to the roles of the insured
  • Bring controversy and the immediate call for repeal and replacement

“So what happens now — what is at stake?”

PRE-EXISTING CONDITIONS – Short term insurance policies and other alternative coverage plans which turn back the clock to the detriment of those with pre-existing conditions.  Short term and Association Plans do not protect pre-existing conditions or health plan spending limits on your behalf. The current Administration is leading this work-around of the ACA.

COVERAGE MANDATES -Removed with the 2017 tax bill and being used as the spear to have legal invalidation of the ACA. Twenty Republican Attorneys General are suing for the end of the ACA claiming it is “unconstitutional” without pre-existing coverage and the individual mandate to have health care coverage. Now Employer Mandates are being changed. Both will lead to the young and healthy not getting insurance coverage increasing the price tag for the high-risk pool of American who require healthcare coverage. The alternative is bankruptcy or worsening health from not being able to afford the healthcare treatment they require.

OTHER INSURANCE MARKET REFORMS INCLUDING COST FREE PREVENTIVE SERVICES– Short term insurance policies and other alternative coverage plans which turn back the clock in order limit or remove the 10 types of services covered under the ACA. Maternity and Preventive Care are universally absent.

MEDICAID EXPANSION– In the on-going battle over Medicaid, Republicans want to shrink it (cut its spending and add restrictions so it serves fewer people). Democrats want to expand it (increase its funding and reach so it serves millions more people).

medicaid expansion

SUBSIDES IN THE MARKETPLACE– There are two kinds of subsidies: one for premiums, the other for healthcare expenses.  By eliminating the second, the federal government took on additional expense as the first were increased. Downstream impact included increased premiums, and chaos in the Individual Marketplace. By eliminating the cost sharing aspect which level the playing field for the risk pools for healthcare insurers, more chaos will ensue. And costs will go higher for those who remain in the marketplace. Now the Administration is allowing states to use the ACA waiver clause to establish Short Term and Association Plans without subsidies. Increasing the high-risk pool. Increasing cost for those who need health care coverage.

Next week:  Healthcare issues you may not know about

By | 2018-11-20T09:41:43+00:00 November 20th, 2018|Categories: Healthcare|0 Comments

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