Does the outcome of the election have you scratching your head about the future of Obamacare? Here are a few key points to consider over the course of the next few months…
Throughout his presidential campaign, Trump ran on a platform of repealing and replacing the Affordable Care Act (ACA.) In addition, since its enactment, Republicans in both the Senate and the House of Representatives have virtually all opposed the ACA, calling for its repeal. Simply stated, the election of Donald Trump is sounding a call to action for the elimination of Obamacare.
Due to the sweeping Republican victories seen in this election, it is likely that some changes will be made to the ACA over the next four years. While it is largely unclear, at this time, what those changes will look like, Republicans in the past have suggested the following:
- Full repeal of the ACA, with or without a potential replacement health care reform legislation;
- Partial repeal of key provisions (such as the individual and employer mandates), while retaining some less controversial provisions;
- Changes to the Medicare and Medicaid programs; and
- Implementing new policies intended to expand coverage and lower health care costs.
It is important to note that newly elected officials will not take office until early 2017. This means that there will likely be no significant legislative or regulatory changes to the ACA before then. Due to the additional uncertainty for employers, with compliance obligations hinging on the political process, employers may want to hold off on making any large-scale changes related to their employer-provided health care.
If you have an individual policy on the Health Insurance Marketplace (healthcare.gov) or in a private health exchange open enrollment deadlines and requirements are still in effect. The requirement to have insurance still stands and subsidies are still being offered to offset premiums based on income. The outcome of the election does not change your coverage right now!
Regardless of any future changes that may be made, employers that provide group health coverage for their employees must prepare for upcoming ACA deadlines. These may include:
Employer Shared Responsibility Rules. The ACA requires applicable large employers (ALEs) to offer affordable, minimum value health coverage to their full-time employees (and dependent children). Penalties can apply for each month in which an ALE does not offer this required coverage.
Employer Reporting of Coverage. Employers must also report information under Sections 6055 and 6056 to the IRS and to certain individuals about the coverage they offer or provide during the year. Returns and statements for each calendar year are due at the beginning of the following year.
Changes to ACA Limits for 2017. Several dollar limits are adjusted each year, and employer-sponsored plans should be updated to reflect those adjusted limits. For example, the out-of-pocket maximum increased to $7,150 for self-only coverage and $14,300 for family coverage for the 2017 plan year.
Summary of Benefits and Coverage (SBC). Health plans and issuers must provide an SBC to participants and beneficiaries that includes information about health plan benefits and coverage in plain language. The Departments issued a new SBC template and related materials to be used for health plans with open enrollment periods or plan years beginning on or after April 1, 2017.
If you have questions, an AUI agent can help you navigate the ever changing landscape. Buckle up; it is about to get interesting in the health insurance market….again.