NEW YORK — Republicans have shelved their plans to repeal Obamacare, so the sweeping health reform act remains the law of the land.
But with all the turmoil in Washington and the talk that Obamacare is on the brink of collapse, many people might be worried about the impact on them. Stay with us a minute and we’ll break it down.
You can keep your plan, at least for 2017
Obamacare is not going anywhere, at least not this year. Insurers have signed contracts with the exchanges to provide coverage throughout 2017. This means the roughly 12.2 million people who have signed up for policies shouldn’t see any major changes. Their premiums should remain the same, as should their subsidies as long as their income doesn’t fluctuate.
A possible wrench in the system would be if Congress decides not to fund the law’s cost-sharing subsidies, which help reduce deductibles and co-pays for low-income consumers. House Republicans hate these payments, which are made to insurance companies, and even successfully sued the Obama administration to try to stop them.
Now, of course, the GOP controls the White House, and lawmakers have yet to agree to fund the subsidies. If they don’t, some insurers may take this as a breach of contract and try to drop out immediately.
The federal government is still supporting Medicaid
The GOP health care bill would have ended enhanced funding for Medicaid expansion, which means millions of low-income adults would have lost their coverage in coming years. The legislation would have also overhauled and curtailed federal support for the entire program, which covers more than 70 million people.
Since the bill failed, Medicaid remains an open-ended entitlement, meaning anyone who qualifies can enroll. States that haven’t expanded can still opt to do so — a bill moving through the legislature in deep-red Kansas would do just that.
However, Medicaid recipients may see some changes in the near future. Health Secretary Tom Price has encouraged governors to apply for federal waivers to impose work requirements, premiums and other measures on those in the program.
You still have to buy insurance or be subject to a penalty
The individual mandate — which requires nearly all Americans to have coverage — remains in effect. Those who are uninsured could be assessed a penalty, unless they qualify for an exemption.
Republicans in Congress sought to kill this provision, one of the most hated in the health reform law. The Trump administration is chipping away at it. The IRS has loosened its oversight slightly, citing President Trump’s executive order to lift Obamacare’s financial burdens where possible. Trump may try to weaken it further, but he would suffer the wrath of insurers, who say it’s an important way to prod younger, healthier Americans to sign up for coverage.
Employers still have to provide affordable coverage
Companies with 50 or more employees must continue offering affordable coverage to their employees or risk having to pay penalties.
The outlook for 2018 is uncertain
Insurers were waiting to see what came of the Republicans’ efforts to repeal and replace Obamacare. Now that the House bill is on ice, carriers say they need some answers from the Trump administration and lawmakers to determine whether they’ll participate on the exchanges next year.
Continued funding of the cost-sharing subsidies is at the top of their wish list, but insurers also want the administration to help insulate them from high-cost enrollees by tightening enrollment periods and revamping the risk-sharing programs.
Time is running out. Insurers have to start submitting their policies and premiums to state regulators in coming weeks.
Are you on Obamacare? Has it helped you or hurt you? Are you concerned it will collapse soon? Are you struggling to pay its premiums or deductibles? Email me at firstname.lastname@example.org. You could be featured in a story.