Health insurance used to be something that people received through their workplace. But with rising costs and many people working part-time jobs or as independent contractors, more and more people are responsible for buying their own health insurance policies. If you are one of those people, you have until December 15th to purchase a health insurance policy to cover you for 2017. If you miss that deadline, you'll have to go without insurance and pay a fine.
With the deadline fast approaching and President-elect Donald Trump poised to take office in just over a month, now is a good time to review some of his proposed changes to the current healthcare laws.
The individual health insurance market went through major changes when the Affordable Care Act (ACA) was signed into law President Obama in 2010. It included popular provisions such as allowing young adults to remain on their parents' plans to age 26 and prevented insurance companies from denying coverage for pre-existing conditions. It included less popular provisions such as requiring all individuals to buy their own health insurance policy if they were not covered through a policy at work or pay a fine, and requiring employers with 50 ore more full time employees to provide health insurance to their workers. Subsidies were available for those with income under a certain level and insurance exchanges were established to facilitate applying for credits and comparing insurance polices online. In general, people like the provisions that benefit them, but don't like being told they have to buy insurance or pay higher taxes to pay for the insurance.
In spite of the challenges still facing the health insurance markets and healthcare system, only 26% of Americans want the law to be fully repealed. Most want to see it revised in some way. Roughly 20 million people have gained access to health insurance coverage through the ACA, so repealing it immediately would cause a huge disruption to the market and people's lives. Regardless of that, President-Elect Trump and Republicans have declared that they will do just that, claiming that they will replace it with a better plan.
When asked for specifics about his plan, Trump has been vague. He's repeated popular sentiment of allowing young adults to remain on their parents' plans until age 26 (easy to accomplish) and keeping the ban on pre-existing conditions but canceling the individual mandate (extremely difficult to accomplish). He also wants to increase competition by allowing insurance companies to sell across state lines, but it's unclear what effect this will have on premiums or access for people with smaller incomes.
While we don't have a lot of details yet about how Trump plans to accomplish these conflicting goals, his pick for Secretary of Health and Human Services, Tom Price, put forth a detailed plan for repealing and replacing the A.C.A. His act would allow insurance companies to deny policies to people with pre-existing conditions if they had not maintained continuous insurance coverage. It would also remove the subsidies and replace them with tax breaks that would favor older and more wealthy individuals. Basically, if you spend more on health insurance, the government gives you more of a tax break, regardless of your income level. The individual mandate would be eliminated and businesses would be free to cancel their group insurance plans at their discretion.
While Republicans tend to blame all of the rise in the cost of healthcare and insurance premiums on the Affordable Care Act and claim it is a total failure, their failure to authorize funding promised under the plan has added to the costs of the overall plan and helped to push insurance premiums much higher this year.
What does this all mean for you? Not much is likely to change anytime soon. If you bought insurance privately or thorugh Covered California last year, renew it again before December 15th, so that you won't have to pay the penalty. If you don't renew now, you have to wait until the following November to purchase a policy, unless you have a triggering event that allows you to buy coverage outside of the enrollment period.
Even if you don't qualify for a subsidy, you can compare plans and purchase your insurance on the exchange. If you find the policies are too expensive for you and your family, consider looking for a job that includes health insurance coverage. Premiums are likely going to continue going up and group plans through an employer are more cost effective.
Unfortunately, there is no easy, inexpensive answer to the health insurance problem. Health insurance premiums are high because healthcare is expensive, especially here in America where our system is structured inefficiently. Also, more people in our country believe that access to health care is a privilege, not a right, so it will continue to be expensive and not guaranteed.
Their are a few things you can do to cut your healthcare costs:
- Stay healthy by exercising regularly, eating healthy, nutritious food and taking supplements to boost your immune system.
- If you can't afford health insurance, research doctors and medical providers in your area to find good quality providers and try to arrange a discount for paying cash for their services. Medical providers spend a lot of money and time on billing and fighting insurance companies, so they are often willing to give a discount in exchange for immediately payment.
- Start a savings account for healthcare costs. Set up an automatic transfer each payday to this savings account. When the need arises, at least you'll have some cash on hand to pay those out of pocket costs.
- Find a job that includes health insurance or ask your employer for a raise to cover the cost of your own premiums. With the economy improving and unemployment low, now is the time to make the request.
With a change in leadership of the country, expect lots of changes in the coming months and years. And if you're not happy with them, pick up your pen and write your Congressional representatives!