The Future of the Affordable Care Act
While Congress ruled against overturning the Patient Protection and Affordable Care Act (ACA) in 2017, the future of the law and its policies is still uncertain.
Recently, the Centers for Medicare and Medicaid Services (CMS) made a final ruling that gives states more control over individual health plan coverage, such as:
- Enabling states to choose their own essential health benefit (EHB) benchmark plan.
- Allowing states to request reasonable increases to the revenue an insurance company can retain after paying claims and overhead expenses — in the past this “medical loss ratio” resulted in some consumers receiving premium rebates.
- Allowing insurers to raise premiums from the previous 10 percent threshold to 15 percent before requiring state regulator approval.1
Last year, the Trump administration eliminated federal government reimbursements to insurers for cost-sharing reduction (CSR) payments. The ACA requires that insurers offer reduced cost-sharing via silver-level plans to low-income consumers with incomes up to 250 percent of the poverty level.2 Now that the government will no longer subsidize those discounts, the Congressional Budget Office (CBO) expects 2019 silver plan premiums to increase by 34 percent.3
Although the ACA is still in force and greatly appreciated by millions of Americans who previously could not afford or qualify for health insurance, these new policies could cause smaller health insurance companies to exit the market. However, midterm Congressional elections could determine whether ACA will cease to exist, be bolstered or even be replaced. A recent Washington Post-Kaiser Family Foundation poll revealed that more than half of Americans (51 percent) are in favor of the government creating a single-payer national health plan.4
1 Centers for Medicare & Medicaid Services. April 9, 2018. “CMS issues final 2019 Payment Notice Rule to increase access to affordable health plans for Americans suffering from high Obamacare premiums.” https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-04-09.html. Accessed May 3, 2018.
2 Henry J Kaiser Family Foundation. Oct. 27, 2017. “How the Loss of Cost-Sharing Subsidy Payments is Affecting 2018 Premiums.” https://www.kff.org/health-reform/issue-brief/how-the-loss-of-cost-sharing-subsidy-payments-is-affecting-2018-premiums/. Accessed May 10, 2018.
3 Health Markets. April 23, 2017. “Healthcare Reform News Updates.” https://www.healthmarkets.com/resources/health-insurance/trumpcare-news-updates/. Accessed April 23, 2018.
Money Saving Tips
On-Demand Health Care Companies
Health care is an industry with seemingly more issues than solutions. However, today’s “on-demand” economy challenges the way medical care has been delivered and helps solve some of today’s challenges.
The on-demand economy focuses on the immediate conveyance of goods and services on an as-needed basis. In health care, startup companies are finding new ways to meet this demand. More frequently, these ventures are resonating with patients and their loved ones as a more efficient and cost-effective way to procure medical or care services without having to use conventional, expensive and time-consuming channels. The following are a few examples of health care companies that are meeting today’s challenges.
- Buoy: Many people Google their symptoms as a first line of defense against a health condition. However, that search can yield unreliable results. At buoyhealth.com, you can enter your symptoms and answer a series of questions that adapt in real time based on your answers. Because the information pulls from a foundation of strictly medical data, it eliminates some of the weird and wacky responses you may receive from a Google search.1
- Forward: This high-end concierge medical service focuses on prevention through data and artificial intelligence (AI). The company uses lab tests and full-body scanners to compile a wealth of data on each patient. Rather than wait for symptoms to manifest, examination data is updated annually to help detect potential conditions based on anomalies in vital signs, blood tests and other screenings. Recommended for use in addition to health insurance, Forward charges $149 a month for unlimited access to its medical staff, baseline screening, blood and genetic testing, wellness and nutrition counseling, ongoing monitoring from wearable sensors, support, and access to its AI.2
- Heal: Currently only available in Los Angeles, Orange County, San Diego, San Francisco/Silicon Valley, Sacramento, the Inland Empire and Washington D.C./Northern Virginia, Heal sends physicians on house calls. The service works with certain health insurance plans, or anyone can pay a $99 fee per appointment. Patients may schedule a doctor to visit their home at a specific time between 8 a.m. and 8 p.m., 7 days a week, 365 days a year. The Heal.com website provides a list of services best suited for house calls including pediatric, urgent and primary care.3
1 Buoyhealth.com. 2018. https://www.buoyhealth.com. Accessed April 23, 2018.
2 Sarah Buhr. TechCrunch. Jan. 17, 2018. “Forward, a $149 per month medical startup, aims to be the Apple Store of doctor’s offices.” https://techcrunch.com/2017/01/17/anappleaday/. Accessed April 23, 2018.
3 Heal.com. 2018. https://heal.com. Accessed April 23, 2018.
What’s New in Veteran Health Care?
The Department of Veterans Affairs is going beyond prescription medications to help ex-service members deal with conditions such as PTSD, depression and pain management. In recent years, medical facilities have received funding to explore alternative therapies such as yoga, mindfulness and breathing training, and tai chi (including wheelchair tai chi classes).1
These eastern-based holistic practices have long touted the benefits of body harmony, observing that practitioners tend to be more engaged in a proactive life and are better able to manage a wide range of mental and physical symptoms. Vets have credited these alternative forms of treatment for helping with panic attacks, pain management and smoking addiction.2
Our firm is not affiliated with or endorsed by the Department of Veterans Affairs or any governmental agency and does not provide benefits advice.