The State of Health Insurance
Fresh from the Minnesota Association of Health Underwriters’ (MAHU) 75th Annual Convention the news continues to be the same: changes, challenges and uncertainties. The Affordable Care Act (ACA) is still the law of the land at this writing but continues to be challenged. While the current Administration and Congress have touted Repeal and Replace but have so far fallen short in the Senate, where it seems to remain deadlock with a hard Sept 30th deadline to revive. Regardless of the semantics used to describe the process, the most likely option is to pass changes to parts of the ACA – most likely through the National Budget process in the form of waivers or addendums to sections of the current law.
The main area which MAHU/NAHU is addressing is the need for a reinsurance program, a very successful program Minnesota had prior to the ACA, which would create premium stability against excessive losses due to claims for carriers in the individual health insurance marketplace. Minnesota has made this request and is waiting for Congressional review and decision.
Other important areas being discussed surround employee mandates. A proposed bill sponsored by Bill Cassidy (R) and Lindsey Graham (R) which was heard September 18 and focuses on making the ACA mandates apply only to employers with 500+ employees. Another area of impact would be changes to the definition of a full time employee. Currently that definition is any employee who works 30 hours or more. The proposed change would define it as a person working 40 hours or more. This would decrease the burden and cost for many small businesses allowing them to offer alternate health plans and programs not as strictly regulated by the ACA. Businesses with large part time and seasonal employees, for example the service industry, would see greater plan and carrier options to offer their employees. Finally, there is heated discussion surrounding the repeal of the Medical Device Tax. In theory eliminating this tax would decrease the cost of care by lowering the price of claims. According to some advocates this ultimately would allow carriers to keep premiums lower each year. Open Enrollment for individual health care plans begin November 15 and end December 15, 2017.
In the Medicare world, Minnesotans need to begin to brace for certain change on January 1, 2019. This change has nothing to do with the health care debate in Washington related to the Affordable Care Act. These are changes implemented by Medicare that will be taking effect in the future. Approximately 260,000 Minnesotans enrolled in Medicare Cost Plans could be affected when Cost Plans face discontinuation in many counties across Minnesota. This rule change in Medicare also affects populations in MD, VA, and Washington DC. All of the carriers have reacted with changes to their existing plans or introduced new plans for 2018 to make the 2019 transition easier. Finally, announced changes to Medicare starting January 1, 2020 will affect individuals with Medigap plans. All newly purchased 2020 Medigap plans will require individuals to pay the Part B deductible. Those enrolled in Medigap prior to 2020 will not be subject to this change. 2020 will also usher in the loss of several Medigap, both High Deductible options. It is still only 2017 so let’s not get too far ahead of this – a lot can change in a few years! Once again, it is very important to reach out annually to your Medicare or health insurance professional this Annual Election Period starting October 15 – December 7 to ensure that your coverage best meets your current and anticipated healthcare needs. You can also visit Medicare and MNSure for additional information.
Peter Hallberg
The Medicare Shoppe
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