Tag Archives: obamacare

Economic Burden of Affordable Care Act

Economic Burden of Affordable Care Act

Topic: Minimizing the Economic Burden of Affordable Care Act Pending Repeal

On President Trump’s first day in office we all heard about the executive order (EO) he signed “Minimizing the Economic Burden of Affordable Care Act Pending Repeal.” Basically, to put it in plain English, what this EO did was give the departments and agencies associated with enforcing the Affordable Care Act (ACA) the authority to ensure the law is being implemented and ease the burden of the ACA during this transition to repeal and replace.

Did the Executive order repeal Obamacare?

No, the EO did not repeal any part of Obamacare or the ACA and does not directly mention any legislation or regulation that President Trump is directing to be eased, repealed, rescinded or amended. This EO just re-enforces the power that Congress, the departments and the agencies already have to move so that changes can be made quickly to ease the economic burden of affordable care act.

Current legislation

Freedom Benefit Solutions will continue to keep you updated on any other EOs, legislation or regulations as they are released. Until then, all statutes and regulations originally enacted by the ACA continue to be in place.

What about my policy?

At this time, we do not recommend making any changes to your current policy.  We do however recommend selecting a plan for 2017 as if no changes will be made by the Trump administration.  We are not certain how long the repeal and replace process will take, nor if the penalty will still be in effect during that time.  We have many different plans to choose from, and can help you decide which plan may be best to fit your needs and budget.  Call or get a FREE QUOTE today!  Open enrollment ends Jan 31, 2017.

Click here to view the executive order “Minimizing the Economic Burden of Affordable Care Act Pending Repeal.”

special enrollment

Life events can change insurance

Some of our biggest life events that trigger special enrollments and change our healthcare coverage too.

Under the Affordable Care Act, many life events, such as losing a job, having a baby, moving, divorcing and getting married, allow people to sign up for health insurance throughout the year, outside of the annual open enrollment period.

Obamacare enrollment runs from Nov. 1 through Jan. 31 for 2016 coverage.

Young adults are more likely than any other age group to experience a life event that qualifies them for special enrollment

Once people understand that getting married, having a kid or moving can be an opportunity to enroll in affordable care, people are interested in hearing about their options. Especially if they picked a plan they are not so happy with.

One thing to remember though, there is only a limited period of time to get a new health policy when these life events happen.

As a general rule, you have to enroll within 60 days of a qualifying event. It’s not an open window.

Not all big life events can alter your insurance coverage — at least not immediately.

Pregnancy

Having a baby, triggers an opportunity to switch health plans, but most people are suprised to find out that pregnancy does not trigger an opportunity. Pregnancy doesn’t allow you to switch plans, it only allows you to add the child to the plan.

Here are some common reasons people qualify for a special enrollment period under Obamacare:

Losing insurance

The reasons for losing insurance are varied – The loss of a job-based plan, aging out of a parent’s coverage at the age of 26, losing coverage through divorce, or losing eligibility for Medicaid or the state’s insurance program for people with low incomes, trigger a special enrollment period.

Most people feel COBRA is their only option. They aren’t aware that after leaving or losing their job they can sign up for a plan and even apply for a tax credit to lower their insurance costs.

Once you elect COBRA, you can’t just drop it. If you continue your current job-based health plan through COBRA, you’ll have to keep it until it ends or the next annual open enrollment comes around when you can sign up for a new plan. Canceling COBRA before it expires does not count as a qualifying event triggering a special enrollment period.

In fact, losing insurance because of something you do yourself — say, stopping payment because you believe that your plan is too pricey — won’t qualify you for a special enrollment period.

Moving

Most health plans operate within a specific geographic area. If you permanently move to a new city or ZIP Code, you may qualify for a special enrollment period and have the chance to pick a new plan.

If you move to a ZIP Code where another plan is now offered or a plan that was offered is no longer available, that’s a qualifying life event.

Marriage – Divorce – Adoption

You can add someone to your health plan if you get married, or if you have or adopt a child. Losing insurance coverage because of divorce also qualifies you to buy a new policy during a special enrollment period.

There are a few other special events that may trigger a special enrollment opportunity. To learn if you qualify for special enrollment email us directly or call 877-740-8683 and we will be happy to assist.

No Obamacare

What is Obamacare

Everyone is asking … What is Obamacare?

Most people don’t want Obamacare because their doctors will not take it.  I want to clarify something …

Obamacare is NOT an “insurance plan”. 

The term “obamacare” is referring mostly to HMO plans, and there are very few doctors taking the HMO plans (with any insurance company).   The reason why most doctors don’t want to take the HMO or Obamacare as it’s called, boils down to money.  Basically the insurance companies pay the doctors less money to treat patients who have those policies.  In addition, there can be more restrictions to the types of treatment the doctors can provide even to the extent that someone at the insurance company may determine what is “medically necessary” NOT YOUR DOCTOR.

The insurance you buy “on the exchange” at healthcare.gov is still insured by the insurance companies.   It is the same insurance that you would buy “off the exchange” either direct with the company or through an agency like us.  Same price, same benefits, same networks.  We generally tell people only buy “on the exchange” if you are applying for a subsidy or want help paying the premiums for the insurance.  Otherwise, just buy direct with the insurance companies through and agent and then your information isn’t being sent to the government.

The Obama administration made the laws that all the insurance companies have to follow.  Therefore all insurance plans have to provide certain benefits.  The doctors are kind of misleading the public by saying they won’t accept Obamacare, but I think it is more of an education issue rather than intentionally misleading.

When purchasing your insurance this year, you want to make sure to check the networks.  If your doctor is listed in the network for that insurance company then he takes the insurance.  If you need help determining which plan to choose, or which plan your doctor will accept, go to www.FreedomFreeQuote.com and get help.

If you are still confused, just stick with a PPO plan, you shouldn’t have any doctor calling it Obamacare!

Obamacare Premiums to Soar in Most States

As we anticipated … we are now hearing from the media how much Obamacare premiums will be, and who is really going to pay.  Read the post below on CNNMoney for more information.

CNNMoney.comBy Tami Luhby | CNNMoney.com – Tue, Aug 6, 2013 5:57 AM EDTA Tea Party member reaches for a pamphlet titled "The Impact of Obamacare", at a "Food for Free Minds Tea Party Rally" in Littleton, New Hampshire in this October 27, 2012 file photo. REUTERS/Jessica Rinaldi//Files

Reuters – A Tea Party member reaches for a pamphlet titled “The Impact of Obamacare”, at a “Food for Free Minds Tea Party Rally” in Littleton, New Hampshire in this October 27, 2012 file photo. REUTERS/Jessica …more 

Get ready to shell out more money for individual health insurance under Obamacare … in some states, that is.

While many residents in New York and California may see sizable decreases in their premiums, Americans in many places could face significant increases if they buy insurance through state-based exchanges next year.

That’s because these people live in states where insurers were allowed to sell bare-bones plans and exclude the sick, which has kept costs down. Under Obamacare, insurers must offer a package of essential benefits — including maternity, mental health and medications — and must cover all who apply. But more comprehensive coverage may lead to more expensive insurance plans.

Under Obamacare, all Americans must have insurance coverage starting in 2014 or face penalties of $95 or 1% of family income, whichever is greater. Enrollment in the exchanges begins October 1, with coverage kicking in in January. Plans will come in four tiers, ranging from bronze to platinum.

Some lightly regulated states, including Indiana, Ohio, Florida and South Carolina, have recently released preliminary rate information highlighting steep price increases. Unlike the blue states of California and New York, these are Republican-led states that have strongly opposed the Affordable Care Act, as Obamacare is officially known.

Comparing this year’s and next year’s plans isn’t easy because the structure of the plans is so different. Each state comes up with its own method.

Behind the numbers in 3 key states. In Florida, for instance, officials constructed a hypothetical silver-level plan based on the offerings available today. Then they looked at how the cost of that plan compares to the average silver plan that will be available on the exchange. Florida found premiums will rise between 7.6% and 58.8%, depending on the insurer. The average increase would be 35%.

The main driver of the premium increases is the Obamacare mandate that coverage be offered to everyone, said Kevin McCarty, Florida’s insurance commissioner. There are just short of a million enrollees in the individual market in Florida, while 3.8 million are uninsured. The state does not allow new entrants into a “high-risk pool,” which provides coverage to the sick.

“People who are in their 50s with high blood pressure have no coverage options,” he said.

Ohio, meanwhile, said there would be an average increase of 41% by comparing a trade association’s report of premiums for all plans available today with the average premium expected on the exchange.

Indiana officials said prices would rise an average of 72%. But they were looking at the cost of providing care, not actual premiums.

All of these rate hikes must still be reviewed by the federal government and do not take into account the fact that Americans with incomes up to $45,960 for an individual and $94,200 for a family of four will be eligible for federal subsidies.

So why aren’t there such big premium increases in other states? New York, for example, already required that insurers provide comprehensive coverage to all who apply. Rates there could fall by half since the pool will expand to include many younger, healthier residents under Obamacare. But New York is more the exception than the rule, experts said.

Rate hikes depend on age and gender. To give consumers a better idea of how premiums will change, CNNMoney took a look at the plans provided by one insurer: Physicians Health Plan of Northern Indiana.

Our analysis found that 21-year-old men will pay a lot more for an exchange plan, but 42-year-old women and 62-year-old men will shell out less for a silver-level plan that comes with a $2,500 deductible and a roughly $25 co-pay for office visits.

Under this scenario, a young man’s monthly rate will rise to $214 on the exchange next year, up 63% from today. The woman, however, will pay $284, a drop of more than 7%, while the older man will be charged $615, a nearly 6% decrease. This is because Obamacare requires that women pay the same amount as men and does not allow insurers to charge older participants more than three times the young.

Physicians Health expects most enrollees to sign up for bronze or silver plans, which have lower monthly premiums but carry higher deductibles and co-pays, according to Jim Brunnemer, the insurer’s chief financial officer. Today, its members typically buy high deductible plans.

While premiums may go up in these states, Obamacare advocates say people will receive more comprehensive coverage. Also, the law limits the amount people have to pay out-of-pocket for deductibles and co-pays to $6,350 in 2014.

“A lot of people will get more for their money,” said Sarah Lueck, senior policy analyst for the Center on Budget and Policy Priorities. “Even people paying a higher rate will benefit. It will be a big change in most states.”

View this article on CNNMoney

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As always, we will be your source for the Open Enrollment beginning October 1, 2013.  Give us a call or visit our website for quotes and to determine if you qualify for a subsidy, how much and how to apply.

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