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ACA? OE? OMG. What’s up with health insurance?

Even under ordinary circumstances, health insurance is a seriously complex topic. This year, navigating the health care landscape is more challenging than usual.

So we’ll start by skipping the maze and going straight to what we know. The Affordable Care Act (ACA) is still in effect.

The ACA was enacted in 2010 to make health insurance available to every American. It established new rules, with the biggest ones hitting the “individual marketplace” (when people shop for insurance for themselves instead of getting it through employers, Medicare or Medicaid). These include:

  • Carriers can’t turn anyone down for pre-existing conditions or impose lifetime caps on coverage
  • Individuals must carry basic coverage (emergency care, maternity care, hospitalization, Rx drugs, etc.) or pay a penalty

The ACA, sometimes called Obamacare, also created “Health Exchanges” where people can buy plans from insurance carriers – including plans subsidized by the government for households that qualify. Also, the ACA began making tax credits available to qualifying households to lower the cost of insurance (plug: if you shop through Mylo, you can calculate whether you have one coming.)

Finally, the ACA established a specific time period called Open Enrollment (OE) when anyone can enroll in health insurance. That’s still in effect too. This year’s dates are Nov. 1 – Dec. 15, 2017. That’s half as long as in previous years, but certain states have already extended the deadline:

  • California – January 31
  • Colorado – January 12
  • Connecticut – November 22
  • District of Columbia – January 31
  • Massachusetts – January 23
  • Minnesota – January 14
  • New York – January 31
  • Rhode Island – January 1
  • Washington – January 15

Outside of this window, you can only enroll in health insurance if you’ve had a Qualifying Life Event (such as losing coverage, getting married or divorced, having a baby, etc.) More details here.

So that’s what we currently know.

Now let’s look at how things almost changed … and still could … but haven’t yet!

REPEAL AND REPLACE: A TIMELINE

Fans of the ACA say that it cut the uninsured rate in half, slowed the growth of medical spending, and lifted a burden from people with long-term health conditions. Detractors say it caused premiums to skyrocket because not enough healthy people participated, drove carriers to leave key markets, and imposed unconstitutional burdens on carriers and individuals.

(And that’s not even getting into specific controversies about the expansion of Medicaid, mandates on employers to provide basic coverage … and more.)

Opponents of the Affordable Care Act took control of the presidency, Senate and House in 2017. Since then, there have been several attempts to overturn the ACA – but no clear victory yet.

Here’s a quick look back:

May 4, 2017: Republican leadership in the U.S. House of Representatives, with the support of President Trump, passed the American Health Care Act (AHCA) – intended to both repeal and replace the ACA. It sought to overturn many of the mandates of the ACA, while proposing other means of keeping people insured.

The win was a narrow 217-213. No Democrats voted in favor, and some Republicans were divided over whether it went too far … or not far enough.

The final version included a number of amendments. Read more details here. Hours after this win, the U.S. Senate announced they’d craft their own bill instead of taking this one forward.

July 12, 2017: After crafting their own “repeal and replace” bill called the Better Care Reconciliation Act (BCRA), Senate Republicans chose to postpone a vote because it wasn’t expected to win the required 60 (out of 100) votes. The bill was expected to win zero Democrats and polarize some Republicans along similar lines as the AHCA. Read more details here.

July 27, 2017: Senate Republican leadership put forth a so-called “skinny bill” that would repeal the ACA … but not replace it with a new act. This bill only required a simple majority to pass but failed by a vote of 49-51.

SO WHAT’S NEXT?

Breaking news: there are strong feelings on both sides of the ACA debate.

It probably won’t be ending any time soon – and the uncertainty is being felt throughout the insurance industry (at least we have it on good authority). Some top carriers have left the state health exchanges … and more could do so in the future.

Current developments to watch:

  • The Senate Health committee is holding bipartisan hearings intended to stabilize the insurance markets
  • President Trump has proposed ending payment of subsidies to insurance carriers as an alternative approach to “repeal and replace”
  • Senators Lindsey Graham and Bill Cassidy are leading an eleventh-hour effort to repeal and replace key parts of the ACA before September 30. More info here
  • As of now, it looks like the Health Exchanges in almost all U.S. counties will be covered by at least one insurance carrier for 2018, and premiums are not expected to rise as much as in some earlier forecasts

The Mylo team (along with our parent company Lockton) is keeping a close watch on things and will update you on any changes. For now, some key points to keep in mind:

  • The Affordable Care Act is still in effect
  • Open Enrollment is Nov. 1 – Dec. 15, 2017 (around the corner)
  • If you need to enroll in a new health plan or shop for something better than you have now, it’s good to start getting prepped now. This guide can help.

If you need help navigating today’s uncertain health insurance landscape, call the friendly licensed agents at Mylo! We look forward to helping you out, even if you just want advice.

Or look around our site to learn more about Mylo and compare instant online quotes!

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