by Holley Maher
As someone who works with health insurance, I’m often asked, “Will Obamacare go away after the elections?” In short, no. The ACA is massive reform transforming every aspect of the U.S. health care system, including insurance, taxes, employers and the way doctors are paid. While I’m confident the ACA is here to stay, I’m equally confident it will evolve.
The ACA eliminated pre-existing conditions as well as male/female pricing differentials. While this “guaranteed issue” coverage reduces pricing for individuals with health conditions and many women in childbearing years, unfortunately, the majority of Americans experience sticker shock when they see the pricing for an ACA-compliant plan. Guaranteed issue will stay, but the market will adjust over the next few years and rates will potentially decrease.
HealthCare.gov was introduced in 2014 as a marketplace for consumers to purchase insurance. The only reason a consumer would buy insurance through HealthCare.gov is because he or she is eligible for some form of government funding toward monthly health insurance premiums. Government subsidies are made possible via taxes. Tax funding comes in many forms, and the “pay or play” mandate for employers with over 50 employees is one way the government will fund subsidies and track eligibility. The Cadillac tax (another funding mechanism for subsidies) is the only thing Republicans and Democrats seem to agree on. While the Cadillac tax will likely go away, the tax implications will probably resurface under another name.
The ACA is a complicated beast, and this article only scratches the surface of what will stay and what will evolve. The important thing? Engage a savvy benefits consultant who can navigate the system and find the programs that benefit your company and your employees.
Holley Maher (hmaher@SmartBenefitsPlus.com) is a partner at Maher, Rosenheim, Comfort & Tabash LLC, specializing in group and individual insurance.
Submitted 7 years 182 days ago