Today, I ‘ll discuss some of the upcoming changes to PPACA (Patient Protection and Affordable Care Act, aka Obamacare) that are coming. Yes, I’ve brought some of them up– and because there’s a lot of information, I will continue this discussion tomorrow, too.
As you know, open season (when we are able to obtain new insurance, change our existing plans) starts in 8 days. But, this year, TheDonald has cut the season from 90 days to 45. (He’s also cut funding to smooth the rails for open enrollment by $ 116 million.) Oh, wait- he’s really cut it even shorter. Because he’s elected to shut down the sites for 12 hours every Sunday- the busiest day of the week for site visitors- for “maintenance”.
(Sure. It’s cheaper to hire folks to maintain a site on Sunday than during the week. And, everyone always shuts down when it’s the busiest season of the year. Yup. I’m sure Amazon shuts down on Black Thursday and the IRS closes on April 15th. And, you also bid on that bridge I had for sale in the middle of the Sonoran Desert.)
Most of you heard that a number of insurers were jacking up their rates this year. That was- and is- true. After all, they expected TheDonald to refuse to meet the obligations of funding the subsidies provided the poorer residents of the US so they can obtain insurance. Exactly what he just promulgated as an executive order.
What you probably don’t know is that the insurance companies are obligated to provide those subsidies for those at or below 400% of the poverty line, whether or not the US Government meets its requirement to pay those subsidies. That’s why about 1/3 of the insurance companies (Centene Corporation, Health Care Service Corporation, Florida Blue, Molina Healthcare Inc, and Medica- among others) upped their rates for everyone- so that if the government balked at the required payments, they wouldn’t go belly up covering the obligations of the USA. (Other insurers, like CareFirst [BlueCross BlueShield of the DC areas] have requested permission from Maryland to restate their rates for 2018. Because without those changes- and without the promised federal funds, CareFirst will lose $ 50 million- the amount of its promised [and now evaporated] reimbursement.)
Those subsidies aren’t cheap- they run about $ 7 billion a year. Oh, and TheDonald didn’t just cancel the payments for 2018- he’s stopped them as of the date of his executive order (12 October 2017). So, the insurance companies won’t obtain 25% (3 months’ worth) of the promised funds. (You do understand that the US government works on a fiscal calendar- starting in October; but the health insurance uses the regular calendar. Rates change ONLY in January and must be announced by October of the year before they go in to effect.)
Oh, and that claim by TheDonald that the insurance companies are getting rich from these subsidies? Not even in anyone’s wildest dreams.
The issue is the verbiage in PPACA- the appropriations that cover some of the out-of-pocket expenses and co-pays for the lower-income Americans was not automatically appropriated. But, those costs are required to be covered by the insurance companies.
You should also know that the executive order is not going unchallenged. There are some 20 Attorneys General who are contesting this action. (Let’s also not forget that a federal judge has already decided that the payment of the subsidies is subject to the approval of Congress- it must pass the budgetary item that sets the payments. (More on this tomorrow.) The Obama Administration was contesting this ruling; the current administration has delayed that appeal. However, there also is a bipartisan group of Senators [Lamar Alexander [R-TN] and Patty Murray [D-WA] are the leaders] looking to fund these subsidies, among other factors involved with PPACA improvements/corrections, to boot. If such legislation is passed, the judge’s ruling is moot.)
Tomorrow, I’ll continue to discuss the 2018 options. But, I strongly recommend that you get on www.healthcare.gov NOW- before the crunch. Make sure your password hasn’t expired (or create a new one). Make sure your address and income data are correct. Window shop for the right insurance for you. So, you can act quickly during open season.
I’ll also explain (tomorrow) why you still need to do so- despite your hesitation on the cost of health insurance.
Well, this hits home – not for my husband and me, but in laws who are both on the exchange, both have a number of pre existing conditions, and both whom voted for…just bitten by karma? They are expecting to have to spend a lot of time on finding insurance for next year, and I am going to pass some of the the (non political advice and commentary because they won’t listen otherwise) parts of this on to them.
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The pre-existing condition problem was eliminated by PPACA. And, since the act has not repealed, it’s still in place.
There’s not a lot of political comments in this post (except to counteract the intentional lies…)
I’m glad that his executive order is being challenged – he’s royallying screwing things up when it comes to healthcare – that’s the issue when you put a child in charge of a country!!!
And, as of right now, the emergency request was denied, but the trial continues.
Thanks for the comment, Megan.
Thank you for spreading this information and so well informed. I don’t know how to respond the way I feel. I say it in one word how this President governs: evil! This is an example of so many (EPA, Education, foreign affairs . . .) I hope you will not get sick while this health care disaster continues.
As long as you can get insurance, at least this aspect is acceptable. Don’t forget that pre-existing conditions are still NOT an impediment to getting insurance. That’s the big change for the middle class who don’t get subsidies.
thank you again Roy, for an information filled post.. well, as part of the middle class,,,,:)
Yes, as part of the Middle Class, we all may not have gotten (ok, definitely didn’t) subsidies- but pre-existing conditions (which means anyone over the age of 40, pretty much) can get insurance. Before they would obviate all pre-existing conditions. Which meant the insurance was basically worthless.
I’m so confused over all the different health care plans. When my son-in-law passed away 3 years ago, my daughter couldn’t get insurance because she made a squeak over the minimum she could earn and couldn’t afford it. I know some states opted in to help those in this category but SC didn’t. Also, with the new TheDonald plan, what does that do to medicare? I was watching the news and it mentioned both medicare and medicaid but only talked about medicaid.
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Medicare is totally unaffected by anything PPACA (Obamacare) right now. However, there are plans afoot to slash 1.5 trillion from Medicare and Medicaid so that the rich and the corporations can get their tax cuts.
Even without a subsidy, your daughter should still opt in and get at least a higher deductible plan (and fund an HSA to cover the out-of-pocket expenses).