What Would Happen if Donald Trump’s Healthcare Plan Was Implemented?
Imagine this scenario next year.
In January, President Donald J. Trump asks Congress on his first day in office to repeal Obamacare.
The House and Senate oblige and eight months later on Oct. 1 the Affordable Care Act (ACA) goes out of business.
In its place, the seven-point healthcare plan listed on the Trump campaign website is implemented.
...“It will make the healthcare industry more affordable and more accessible,” Sam Clovis, the national co-chairman and a policy advisor for the Trump campaign, told Healthline.
However, five experts interviewed by Healthline don’t see quite as rosy a picture.
...“Not everybody needs to have health insurance,” said Clovis. “Healthy people having to pay the insurance costs of unhealthy people is a nonstarter.”
The good news about estimating the DC exchange rate hike requests is that the DC Dept. of Insurance, Securities & Banking is pretty transparent about posting this info, and they keep it simple. It's simpler still because like Vermont, DC requires that all individual and small group policies be sold on the exchange, so there's no off-exchange data to track down.
The bad news is that it's a little bit too simple: Only two carriers (CareFrist and Kaiser) offer policies via the individual exchange, and only CareFirst is offering PPOs:
...in terms of following the requirements of the HHS Dept, it's very useful for people to look up their particular company in their state, see what their "average" rate increase request is and submit cranky public comments (which will in most cases probably be ignored, but hey, you never know).
And yes, this certainly makes it easier to fill in some of the missing pieces of the puzzle, and helps cut down on how much hunting around people like myself have to do to track down some of this data. For that alone, I'm extremely glad to see this tool added.
Last year, Indiana was one of only two states to see virtually flat year over year premium increases on the ACA-compliant individual market, with rates going up a mere 0.7% on average. This year, unfortunately, that won't be the case...although at least one carrier, Celtic, is reducing their average rates by over 5%.
The good news is that I was able to track down the average rate change for all 6 carriers offering individual plans in Indiana (UnitedHealthcare is dropping out of the market, and I'm not sure what's going on with Aetna and Coordinated Care Corporation, both of which do have listings in Indiana's SERFF database for 2017...but neither of which has any actual filings listed. I presume these are placeholders for them to potentially enter the state market, which would be a good thing (and which Aetna has already indicated they might be doing next year). In addition, Golden Rule says that they'll be offering ACA-compliant policies starting next year as well (mainly for their current "transitional" enrollees).
The bad news is that while I've hunted down the current enrollment numbers for 5 of the 6 renewing carriers, one of them, MDwise, is frustratingly unknown, making it tricky to calculate a weighted average rate hike. Actually, I only have hard numbers for 4 carriers; for Celtic I had to cheat a bit by using their projected enrollment for next year. At 197,000 member months, that's an average of around 16,400 enrollees both on & off the exchange.
Without MDwise included, the average of the other 5 carriers comes in at 19.25%. However, MDwise is only (only is relative, I realize) requesting an 11.5% average hike, so any additional enrollees from them would bring that average down somewhat. The problem is figuring out how many current enrollees MDwise has:
Amidst all the hand-wringing over how much healthcare premium rates are expected to go up next year, there's one factor which I haven't really mentioned before. I've probably made a passing reference to it here and there, but I don't think I've focused on it prior to this entry.
Old people, generally speaking, require more medical care than young people. This isn't an absolute, of course; there are 60-year olds who can kick a 30-year old's ass, and while younger people tend to be healthier than the elderly, they also tend towards more risky behavior, be it reckless driving, bungie jumping or whatever. Still, the fact remains that there's a reason why insurance carriers lust after so-called "Young Invincibles" so much: They tend to be relatively low-risk and inexpensive to treat when something does come up.
The conventional wisdom when it comes to taxes is that Republicans are always for cutting 'em while Democrats are always for raising 'em. The reality, of course, can be far more complicated--it's not just about cutting or raising taxes, it's also about who's getting the increase/decrease and what the money would/no longer would be used for. Even so, this is an odd-sounding story at first glance.
Just last week, the Big News Shocker out of Oklahoma was the blood-red Republican-controlled state legislature and governor were actually considering a) raising taxes (!!!) and b) expanding Medicaid via the ACA (!!!) in order to dig themselves out of their self-dug financial hole:
So, in what would be the grandest about-face among rightward leaning states, Oklahoma is now moving toward a plan to expand its Medicaid program to bring in billions of federal dollars from Obama's new health care system.
What's more, GOP leaders are considering a tax hike to cover the state's share of the costs.
Carriers file two average rate increase amounts with OHIC: the EHB base rate increase and the weighted average rate increase. These two percentages reflect different calculations.
The survey also finds a lack of awareness about new rules for coverage introduced by the ACA. Among all those with ACA-compliant coverage, fewer than half (47 percent) know that preventive services are covered completely by their plans, while a third (33 percent) think that copays or deductibles apply to preventive services and one in five (20 percent) are not sure. Among those in high-deductible plans, awareness is even lower: 41 know that preventive services are covered with no cost-sharing.
The Kaiser Family Foundation has just released their 3rd Annual survey of people enrolled in the "Non-Group Health Insurance Market", otherwise known as the Individual market. It's important to note that this survey includes Americans enrolled in all individual market plans, both on and off-exchange. There are technically 5 separate categories, although they can effectively be merged into three categories for most purposes:
1. EXCHANGE-based QHPs (Qualified Health Plans)
2a. OFF-Exchange QHPs
2b. OFF-Exchange ACA-compliant non-QHPs
3a. OFF-Exchange NON-ACA compliant "Grandfathered" plans (ie, enrolled in prior to 2010)
3b. OFF-Exchange NON-ACA compliant "Transitional" or "Grandmothered" plans (ie, enrolled in between 2010 and 2013)
I tend to merge #2 & 3 together (off-exchange, ACA-compliant) in virtually all cases, and merge #4 & 5 together (grandfathered/grandmothered) except in cases where I need to make a distinction.
