Now what? Options for law as the drama fades
As the political drama over health care legislation in Washington fades, the rest of the country faces a more immediate concern: Getting insurance for next year.
The Republican health plan designed to replace the Obamaera health law known as the Affordable Care Act would not have taken full effect for a few years anyway — and now it’s dead.
“We’re going to be living with Obamacare for the foreseeable future,” House Speaker Paul Ryan said Friday.
That means millions of Americans will have to navigate a current federal health care system that, while not “imploding” as President Donald J. Trump has said, is at least in flux.
Mary Vavrik, a 57-year-old freelance deposition court reporter from Anchorage, Alaska, said she was relieved that the current health law will remain because she’s happy with the coverage she gets through her exchange — even as she acknowledged that reforms are needed.
“It’s not a perfect plan, but I’m really grateful to have what I do have,” she said.
Prices for insurance plans offered on the public insurance exchanges set up by the health care law have soared in many markets, and choices for customers have dwindled. That’s because insurers have faced sizable financial losses on the exchanges in recent years and have responded by either hiking prices or pulling out of certain markets altogether.
Now, attention will turn to administrative changes underway in Washington designed to stabilize the exchanges by preventing more insurer defections.
The open enrollment period to sign up for insurance for 2018 is slated to start this fall, but insurers are making decisions now about whether to participate.
Plans to choose from?
It depends on where you live. Choices are dwindling, but chances are at least one insurer will sell in your market. That company may offer several plans.
Generally, big cities will have more choices than rural areas where there may not be enough customers to attract insurers.
As of now, there are 16 counties in a region of Tennessee around Knoxville that have no insurers committed About a third of the nation’s 3,100 counties are down to just one insurer.
Insurers have been pulling back, and more are expected to leave, but health care researchers are not predicting mass defections. “For most consumers, (2018) will look a lot like ’17,” said Dan Mendelson, president of the consulting firm Avalere.
Customers can try to find coverage outside their exchange, but then they won’t be able to use tax credits to help pay the bills.
Are there fixes in store?
Last month, the Health and Human Services Department, which runs exchanges in many states, proposed some adjustments to try to stabilize these marketplaces.
For example, insurers want greater scrutiny of people who sign up for coverage outside of the open enrollment period. Customers are supposed to be allowed to do so only if they have a lifechanging event like the birth of a child, a marriage, or the loss of a job that provided coverage, but insurers have found that people are just waiting to sign up when they need care.
Another proposed adjustment would let insurers design cheaper plans tailored to younger people who may not need lots of health care but want to be protected in the event of a big injury or sickness.
That could be very helpful.
Is the affordable care act “imploding” as president Trump has said on twitter?
No. The marketplaces are not expected to dissolve next year, even though choices have dwindled.