Today eHealth, Inc. (NASDAQ:EHTH) (www.ehealth.com), the nation’s first and largest private online health insurance exchange, released answers to questions health insurance shoppers may be asking about Republican proposals to replace the Affordable Care Act (ACA, also known as Obamacare).
“Serving the needs and interests of health insurance shoppers has been our number one job since 1997, and we’re more committed to it than ever,” said eHealth CEO Scott Flanders. “Consumers are confused about the future of health reform in the United States right now, and Republican proposals to alter or replace the ACA are not yet written in stone. But the cost of coverage under the ACA has been a burden to many and eHealth will continue to support any proposals and legislative solutions that put affordable, flexible health insurance coverage within the reach of all Americans.”
Answers provided to the “Frequently Asked Questions” below seek to clarify the impact of a potential Republican proposal for consumers. Answers are based in part on draft proposals published in June 2016 by Republicans of the House of Representatives and by President-Elect Donald Trump’s campaign.
Frequently Asked Questions:
What
Does the Future of Health Reform Look Like?
Q: Is the Affordable Care Act going away?
A: The
Affordable Care Act is still the law of the land. President-Elect Trump
has promised to ask Congress to repeal and replace it early in his
administration, but it’s not likely that significant changes could come
into effect until well into 2017 at earliest.
Q: It’s open enrollment season right now, so should I still shop for
2017 health insurance coverage?
A: Yes. Everyone should
have health insurance, and now is the time to shop. Without coverage,
you leave yourself open to potentially burdensome medical bills, or even
bankruptcy. If you want coverage under a new plan to begin by January 1,
2017, you typically need to enroll by December 15, 2016. Open enrollment
is scheduled to continue through January 31, 2017.
Q: If I buy a plan now, can I cancel it next year if new options
become available?
A: Yes. When you enroll in a new plan,
you are not committing to keeping it all year. If you prefer to enroll
in a new plan in the future, you can cancel your current coverage at any
time.
Q: Are there other options if I really can’t afford to buy an
Obamacare health insurance plan today?
A: You may want
to consider a short-term health insurance plan. Just be aware that
short-term coverage is not a full replacement for an Obamacare health
insurance plan, for many reasons. For example, unlike Obamacare plans,
short-term plans typically consider your pre-existing medical
conditions, so you may be denied coverage or face waiting periods or
certain exclusions related to pre-existing medical conditions. Most
short-term plans are significantly more affordable than major medical
plans in terms of monthly premiums. However, short-term plans do not
count as minimum essential coverage under Obamacare because they
typically cover much less than Obamacare plans. As such, short-term
plans may leave you open to a potential tax penalty under the Affordable
Care Act if you do not qualify for an exemption from the tax penalty.
There are also limitations on how long a short-term plan can be in
effect, with many plans next year expected to be available for terms of
only 3 months or less. Rules regarding short-term plans may change under
a Trump administration.
Q: Would Republican proposals eliminate the health insurance plan I
have now?
A: Neither Donald Trump’s nor the draft House
Republican proposals are designed to eliminate specific health insurance
plans. However, if the ACA is repealed or changed, it is likely that
insurers could decide to change or stop offering some of the plans they
currently offer, especially plans currently sold through government
exchanges.
Q: Will the tax penalty for going uninsured go away?
A: Probably.
Both the draft House Republican and Donald Trump’s proposals would
repeal the tax penalty for not having Obamacare-compliant health
insurance coverage. However, it is not clear when such a change would
take effect or how the details of the repeal would work, if it happens.
Q: Will there be a specific open enrollment period?
A: Under
the draft House Republican plan there would be an initial open
enrollment period during which anyone can apply for coverage at the
standard rate (that is, the rate a healthy person with a history of
continuous coverage would typically pay). After this, you could be
required to pay a higher rate based on your health status or medical or
coverage history.
Q: What happens if I lose my job, move, get married, or start a
business?
A: Under the draft House Republican plan, your
coverage in such scenarios would likely still be “guaranteed issue” if
such events count as a qualifying life event under the new plan. This
means that pre-existing medical conditions could not affect your
eligibility for coverage and you would be able to retain your coverage
or shop for a new plan without being medically underwritten or declined,
so long as you don’t have a gap in your coverage. However, because the
proposals are still changing, it is not entirely clear which events
would count as qualifying life events and what the specific rules may be
that would allow you to purchase a new plan with these protections.
Q: Will I have to pay more for health insurance if I have a
pre-existing condition?
A: Under the draft House
Republican plan, you would not face medical underwriting or higher
monthly premiums based on your health as long as you don’t have a gap in
coverage before enrolling in a new plan.
Q: Will I be able to purchase health insurance from a state where
it’s more affordable?
A: Likely yes. The draft House
Republican plan would make it easier for states to enter into interstate
compacts that may allow the sale of health insurance across state lines.
Donald Trump’s plan would also allow for the purchase of coverage across
state lines. However, it is still uncertain if these proposed changes
would actually result in insurance companies offering more affordable
plans in many states or regions.
Q: Would health insurance benefits be the same as those under
Obamacare-compliant plans?
A: Not necessarily. Neither
the draft House Republican plan nor Mr Trump’s proposals provide details
on health insurance benefits, but it appears that benefits may be more
flexible than those required for current Obamacare-compliant health
insurance plans. For example, you may have the option to enroll in a
plan that does not cover things like maternity care or brand-name
prescription drugs.
Q: Will tax credits or subsidies still be available?
A:
The draft House Republican proposal would allow anyone buying their own
health insurance to qualify for tax credits, regardless of their income.
Under the ACA, tax credits end abruptly once your annual income exceeds
400% of the federal poverty level, but the draft House plan would extend
tax credits to people at any income level. Donald Trump’s proposal would
allow all Americans to deduct health insurance premiums from their
taxable income.
Q: How much will the tax credit be? How will it be determined?
A:
Current proposals do not specify the dollar value of the new tax
credits. However, tax credits could be based on your age and geography
rather than your income. Older people could get a bigger tax credit, as
could people who live in more expensive areas of the country.
Q: What if the cost of my plan is too high even with a tax credit?
A:
The draft House Republican proposal would likely place limitations
on rate increases. Persons still unable to afford health insurance may
be able to turn to state-run high-risk insurance pools, where available,
to buy subsidized health coverage at a reduced price.
Q: What if my tax credit is bigger than my insurance premium? Does
that money go back to the government?
A: You would
likely be able to keep the extra tax credit. The draft House Republican
proposal suggests that you may get to keep any excess tax credits you
receive for use in a Health Savings Account (HSA), to pay for qualified
medical expenses on a tax-advantaged basis. Mr Trump also strongly
supports the broader use of HSAs.
Q: What if I don’t have an HSA?
A: You may want to
consider enrolling in a health insurance plan eligible for use with a
Health Savings Account. Both Donald Trump’s and the draft House
Republican proposals would increase the tax-free contributions you’re
allowed to make to an HSA. A Republican proposal could also allow
employers to contribute to an HSA on your behalf (on a pre-tax basis).
Please note that because the political situation is constantly changing and difficult to predict, it is still uncertain when or if any of the proposals for health care reform described in this FAQ may actually be enacted, either in part or in whole. Furthermore, even if new reforms are enacted, it is very likely that the final reforms will differ significantly from the proposals described in this document. As such, eHealth does not recommend that health insurance consumers drop or change their insurance coverage or take other drastic actions in anticipation of any proposal being enacted.
eHealth
eHealth, Inc. (NASDAQ:EHTH) owns eHealth.com, the nation's first and largest private online health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealth offers thousands of individual, family and small business health plans underwritten by many of the nation's leading health insurance companies. eHealth (through its subsidiaries) is licensed to sell health insurance in all 50 states and the District of Columbia. eHealth also offers educational resources and powerful online and pharmacy-based tools to help Medicare beneficiaries navigate Medicare health insurance options, choose the right plan and enroll in select plans online through Medicare.com (www.Medicare.com), eHealthMedicare.com (www.eHealthMedicare.com) and PlanPrescriber.com (www.PlanPrescriber.com).
For more health insurance news and information, visit eHealth's Consumer Resource Center.
View source version on businesswire.com: http://www.businesswire.com/news/home/20161109006372/en/
Contacts:
Sande Drew, 916-207-7674
sande.drew@ehealth.com
or
eHealth,
Inc.
Nate Purpura, 650-210-3115
nate.purpura@ehealth.com