Despite all the proposals for a replacement, nothing will happen immediately
Just yesterday, the first replacement plan to be introduced since President Trump’s inauguration, the Patient Freedom Act, was unveiled in the Senate by Republicans Susan Collins of Maine and Bill Cassidy of Louisiana.
Efforts to undo ACA, also known as “Obamacare,” have created a lot of uncertainty for consumers who have already signed up or are still thinking of signing up before the Jan. 31 deadline.
For now, at least, policy experts don’t think consumers need to worry about any major changes taking effect if they have ACA health insurance this year. After that, however, all bets are off.
“For 2017, people enrolled in an ACA plan should feel confident that they will have coverage,” says Elizabeth Hagan, a senior policy analyst at Families USA, a nonpartisan consumer health advocacy organization.
So with the enrollment deadline only a week away, Hagan advises people to “sign up and get those benefits while they are still available.”
Hagan says that even with major changes expected, most of the replacement plans proposed so far have a transition period. The Patient Freedom Act, for example, gives states two years to put its proposals into motion.
Consumer Reports’ policy and action team will be reviewing the Collins-Cassidy bill, and others that are likely to be forthcoming, to see if they provide consumers the care they need and deserve.
Already, more than 8.8 million people have signed up for 2017 coverage through HealthCare.gov, and in the first two weeks of January, enrollment was 100,000 higher than the same time last year. Still, worry about the future of Obamacare has left many others unsure about what to do in the short term.
More than 40,000 people have contacted HealthCare.gov’s call center to ask whether they should still sign up for coverage.
In a briefing on ACA enrollment last week, Sylvia Burwell, the outgoing secretary of Health and Human Services in the Obama administration, said people should absolutely sign up. Burwell herself said she will enroll in an ACA plan for her family before the month ends.
What the Latest Replacement Proposal Means
Affordable, quality health insurance is a top concern for Americans. A Consumer Reports Voices survey published last week found that 55 percent of consumers say they are not sure they or their loved ones will be able to afford insurance that will enable them to get good healthcare.
It’s understandable that people feel uncertain. President Trump has made it clear that he wants to have a replacement plan in place as soon as possible, but details have been sparse.
Trump said a plan would be announced as soon as his nominee to head Health and Human Services, Tom Price, is approved by Congress. Price is having a second day of hearings with the Senate Finance Committee Tuesday before a vote is held on his appointment, likely later this week.
Last Friday, Trump issued an executive order against Obamacare, but it’s unclear exactly what its effects will be. The order is broad, giving federal agencies affected by the ACA the authority to “waive, defer, grant exemptions from or delay implementing any part of the law” that would impose a burden on individuals, families, health insurance providers, drug makers, hospitals and medical device makers.
Speaking with reporters after announcing details of the Patient Freedom Act Monday, Senator Collins called the executive order “very confusing” and said “there are some improvements that can be made through the executive order process and through the regulatory process, but that by no means takes away the need for comprehensive legislation.”
As for the Patient Freedom Act, it proposes giving states three options: Keep the ACA structure they have; use the federal funding states get now under Obamacare to give consumers money to buy insurance and pay for their own medical care; or refuse federal funding and design and regulate their own health insurance marketplace. The legislation also calls for automatic enrollment in a bare-bones high-deductible health plan that provides catastrophic and prescription drug coverage (you can opt out) but eliminates the requirement for most Americans to have health insurance or face a tax penalty.
“I don’t think we have any idea yet whether this will become the vehicle to replace the ACA if it gets repealed. But it manifests a very different approach where we might have 50 different health care systems in the country,” says Ron Pollack, executive director at Families USA. “What we do know is that this is likely to result in consumers paying considerably more out of pocket then they do today.”
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What You Should Know If You Plan to Enroll
For now, if you need health insurance through the ACA exchanges for 2017, here’s what you should know.
There are several ACA enrollment opportunities. If you want to sign up for a new plan or switch the one you’re in, you must do it by January 31st. You can sign up for all Affordable Care Act health plans through the website, healthcare.gov, or through your state’s health marketplace website.
The coverage will take effect March 1st. There are special enrollment periods for individuals facing certain circumstances, such as moving, getting married, having or adopting a baby, or losing your employer-based coverage. If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can enroll at any time during the year.
Your policy can’t be cancelled. If you do enroll, there is no risk that your policy will be cancelled during 2017, says Tom Baker, a professor of law and health sciences at the University of Pennsylvania Law School. “These are health insurance contracts governed by state law,” Baker says. “The contract is for a year and the insurance company is not going to be able to raise the price or do anything during the year.”
You may qualify for financial assistance. Even with the ACA, health insurance is expensive. Premiums have risen sharply in the past year and many people are in high-deductible health plans, which require you to spend a big chunk of your own money before insurance coverage starts to kick in. The average premium for Silver plans (the most common plan people sign up for) is up 17 percent this year from 2016. But about 85 percent of people on ACA plans qualify for tax credits that can be paid directly to your insurance provider to cover premiums. People in Silver plans might also be able to get cost-sharing subsidies to cover out-of-pocket costs.