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We have received many questions about the changes that will occur in health insurance coverage with the change in the Administration.  People are most afraid of pre-existing conditions clauses re-applying and they are trying to make the best decisions possible for the January 1 Open Enrollment.

Although I have no crystal ball, I think it is safe to say that any changes that will be made will not be made for a January 1 effective date. That said, many changes are likely and thoughtful preparation would be recommended. Let’s look at two areas where we are most fearful.

Q1 : Will the Affordable Care Act be repealed and what will this mean?

A1 : Repeal or modification certainly appears to be on the new administration’s agenda. Which provisions will remain and which will be changed is hard to predict, but it is unlikely that extensive changes will come quickly. The new president will not be sworn into office until the latter part of January, Congress will have to vote and a new plan will need to be developed. Certainly all of this will take a bit of time and it would seem logical that, while small changes can be implemented quickly, more complex ones like medical underwriting will take a bit more time.
Q2 : Will individuals who are not healthy enough to pass medical underwriting standards be removed from the healthcare system?

A2 : Guaranteed issue of health insurance coverage was a huge benefit afforded to many people by the Affordable Care Act. Pre-ACA individuals could have paid into the system for decades and found themselves thrown out for a variety of situations beyond their control. People’s immediate fear of a return to that system has produced most of the phone calls to our office. The trade-off between guaranteed issue of health insurance and the requirement of mandatory minimum coverage will need quite a bit of time to be analyzed so we do not expect a return to the past any time soon. And let’s not forget one thing: under the Affordable Care Act health insurance underwriters were expendable and thus released from employment. In addition to re-establishing medical underwriting guidelines, I assume that it will take a bit of time to locate the individuals who were trained in this skill set.

In short, change is coming and we need to speak up with our thoughts. Letters to our Congressional leaders, candid conversations with those who represent opinions different from our own and any other venues to have our opinions considered will be critical. This is no time to sit back and let the tide sweep us where it will.

Remember, the problem with health insurance costs has historically not been how bills are paid, rather how they are incurred. We will focus our next article on how best to adjust to the changes that are coming and particularly on how to navigate the options available outside of the traditional health insurance system. In the meantime, if you have further questions don’t hesitate to reach out to us at CDA, Inc.