It’s 2018 and if your heart is still beating, which we surely hope it is, then you definitely need to know about the changes coming to the healthcare system in the US this year. Although government efforts to “repeal and replace” the ACA (Obamacare) were largely prevented, there are a number of amendments that Congress was successful in implementing. While these changes will affect nearly every American Citizen, the healthcare industry can be a very complicated and tedious topic to navigate and understand. That is why, without getting too political, we at VisualFizz have put together the 2018 Healthcare Changes in language us regular humans can understand.
CSR payments to insurers were eliminated in October of 2017. Industry experts have overwhelmingly agreed that such a move will result in insurers raising the rates of premiums to compensate for the loss. The evidence of this change will be reflected in an overall rise in premiums for “silver-level insurance plans” which is one of four levels of insurance that are available for enrollment under the ACA.
The effect of the CSR elimination will be offset slightly by the Advanced Premium Tax Credit (APTC), the benefits of which increase as individual premiums go up. This means that beneficiaries of the APTC will likely be unaffected by the elimination of the CSR (a good thing for the regular joe). For the unsubsidized, however, a large increase in rates can be expected.
Due to the rise in premiums, a sizeable percentage of lower income individuals may find it cheaper to opt out of ACA coverage and pay the penalty for violating the ACA individual mandate than to enroll an insurance plan.
Medicaid Expansion Efforts
According to a Kaiser Health poll taken in February of 2018 “74% of Americans believe the Medicaid program is working well for most low-income people covered by the program” Due to Medicaids wide-spread use for many Americans, many states have passed ballot initiatives to expand the Medicaid program, with only eighteen states having yet to pass similar legislation.
Under previous administrations, the open enrollment period for healthcare insurance plans was three months long, spanning from November 1st – January 31st. Under the new rules and regulations, open enrollment has been reduced to just six weeks, running from November 1st – December 15th.
Stricter Rules Surrounding Special Enrollment
If you missed open enrollment, you’ll need to have had what is referred to as a “qualifying life event”. HealthCare.gov defines a qualifying life event as “a change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period” Without a qualifying life event, it may be difficult to qualify for special enrollment under the new rules and regulations. Insurers have implemented tighter restrictions and a tougher verification process in order to weed out potential misuse This means you’ll have to provide proof of the “qualifying life event” in order to qualify for special enrollment.
Changes To Billing Policy
If you changed policies recently, it’s recommended that you contact your previous insurer and confirm your previous policy has actually be canceled and all charges paid. Under the new rules and regulations, insurers can now collect on all fees and charges associated with previous policies that have not been closed, paid in full or expired.
According to the Center for US Health System reform, this new regulation will affect approximately 25% of enrollees who have either forgotten they had an open policy or simply couldn’t afford it.
We at VisualFizz spend a lot of time with our clients in the Health and MedTech industries, and we know how important it is for the individual consumer to stay informed on the healthcare industry and how it can affect you. Thankfully the amount of information available on the subject is vast and we are here to make easily accessible to you. Be sure to check www.healthcare.gov/ frequently for updates on the ACA, as well www.visualfizz.com/ for latest on what is affecting regular humans today.