In the early days of the Trump Administration, the Republican Party tried to repeal and replace the Affordable Care Act, also known as Obamacare. Though the effort was a failure, things can still change. House Speaker Paul Ryan declared that their party will continue their efforts to change the law on health insurance in the near future. When buying a health insurance plan in 2017 you will need to take these efforts into account.
The Republican Party does have the support of the majority in Congress and the Senate, and the President is a Republican as well. So things can change in a hurry. In fact, changes can also be made without Congressional help, simply in changing certain regulations in the law and in how the ACA is administered.
The following scenarios can still happen for this year:
- Obamacare may atrophy due to lack of government attention and funds. Obamacare maintenance involves monitoring and running the websites, and people have to be hired to answer questions on the helpline. However, the White House can just choose to deprioritize these operations.
Such efforts already started in the current President’s first week in office, when the advertising and the outreach programs were scrapped. Now emails are no longer sent to the people who visited the site, to help convince them to get insurance.
- Regulating new definitions for EHBs. One of the significant elements of Obamacare requires health plans to provide 10 “essential health benefits” in the coverage. But the Obamacare defined what those EHBs meant through regulation, and the Trump administration can do the same thing.
For example, “preventive care” is one of these EHBs mandated by the law. The Obama administration included copay-free contraception as part of preventive care. That can change now, as HHS Secretary Tom Price had already stated his opposition to this in the past.
- No more penalties. Another key element of Obamacare is that if you didn’t get proper health insurance, you had to pay a tax penalty. But now this may change as well. But a Trump executive order directed the IRS to accept “silent returns”, which are tax returns where it’s not stated whether the person has health insurance or not.
In addition, more hardship exemptions may be granted. Obamacare allowed some people not to have insurance for special cases, and they weren’t penalized after being granted a hardship exemption for cases such as bankruptcy, homelessness, and domestic violence.
But it’s possible that more exemptions can be granted, so that there’s no not much of a penalty at all. This means that there’s no more punishment for those who neglect to get proper health insurance.
- No more subsidies. Obamacare also help pay for out-of-pocket expenses through tax subsidies. A group of House Republicans challenged this provision in court and won their lawsuit, although the subsidies are still applied pending an appeal. But because the Republicans now have the White House, they can simply not appeal at all and the subsidies can disappear.
What all these potential changes mean for the moment is that if you’re a US citizen, you need to get a proper health insurance now while Obamacare allows you to get them for cheap. After these changes, buying a health insurance plan in 2017 can be a lot more expensive.