Vice President-elect Mike Pence recently said GOP lawmakers intend to keep their promise to do away with Obamacare and replace it with other health care alternatives that will solve the problems the health care law created.
"Make no mistake about it," Pence said during a press conference on Capitol Hill on Jan.4. "We're going to keep our promise to the American people -- we're going to repeal Obamacare and replace it with solutions that lower the cost of health insurance without growing the size of government."
This year, people across the nation can expect to see a variety of Obamacare replacement options that are expected to promote competition within the health insurance industry while driving down health care costs, and according to a health economist. Some changes will come sooner rather than later.
During a recent radio interview on "Chicago’s Morning Answer" hosted by Dan Proft and Amy Jacobson, C. Stephen Tucker, founder and principal broker for Health Insurance Mentors, said that while the plan is to strip away some aspects of Obamacare that are troublesome right away, it’s important for people to know that repealing and replacing Obamacare will not result in disruption of any health care plans for anyone.
“What’s going to happen in the month of January…when President-elect Donald Trump becomes President Trump, he’s going to get rid of the things that were done illegally by (President Barack Obama) pertaining to Obamacare,” Tucker said during the interview.
An example of such is cost-sharing reduction, which became law without Congress, Tucker said, and artificially lowers premiums and deductibles for individuals who purchase Silver plans and are below 250 percent of the federal poverty level.
A few other aspects of Obamacare will be repealed immediately.
“The mandate to purchase health insurance is going to go away, and there are several other onerous provisions that hurt business that are going to be replaced right away,” Tucker said. “And then, throughout the rest of the year, those who have health insurance subsidies will be able to keep them until the end of the year.”
In the fall, new health care products that are less expensive and provide more options for consumers will start entering the marketplace, Tucker said, adding that the claim that Republicans do not have a viable alternative to Obamacare is absurd.
Rep. Tom Price (R-GA), Trump’s nominee for secretary of Health and Human Services, has a bill entitled “Empowering Patients First Act” that is slated to replace Obamacare, Tucker said.
“I’m sure there will be changes as it goes through the Senate, but that will be the bill that replaces Obamacare, and that is one of 19 bills that have been written by Republicans since Obamacare was passed into law,” Tucker said.
Consumers can, however, expect one popular Obamacare provision to remain available to them – keeping kids on their parents’ health care plan until age 26.
“It was actually the law in most states long before Obamacare,” Tucker said.
The major difference between then and now, Tucker said, is that there were certain requirements adult children had to meet to be eligible, like attending college. No such requirements exist currently.
Another aspect of Obamacare that consumers praised is that the law accommodates people with pre-existing conditions. By law, insurers are currently required to sell health care policies equally to everyone, regardless of medical history. This has resulted in higher claims for insurers due to a less-healthy pool of consumers.
“We are going to return to the way pre-existing conditions were covered for nearly 20 years before Obamacare, and that is people who have pre-existing conditions will be able to get coverage for those pre-existing conditions presuming, of course, that they follow HIPAA law,” Tucker said.
The federal Health Insurance Portability and Accountability Act (HIPAA) states that in the employer-sponsored market, individuals who have maintained 18 months of prior coverage will have all their pre-existing conditions covered if they switch policies as long as they do so within 63 days of losing one policy and enrolling in another, Tucker explained.
This will now also be required in the nonemployer-sponsored (individual) market, which will prevent people from gaming the system, he added.
“The crux of the problem with Obamacare, and the reason we’ve lost 19 carriers – 19 health insurance companies, 250 health plans in 36 months…is that people are allowed to game the system by calling healthcare.gov and stating that they lost income,” Tucker said.
A special enrollment period called “loss of income” was introduced by Obamacare and allowed people to sign up for coverage, but gave them 90 days to submit proof of the loss or income. Tucker said evidence points to the lack of stricter provisions surrounding Obamacare enrollment periods being a key reason why insurance companies lost hundreds of millions of dollars.“After they crunched the numbers, actuaries realized that there was a strange correlation between the two periods – when one has ‘loss of income’ and when one has a scheduled surgery,” Tucker said. ”Then they found out that those people dumped those policies on an average of 32 days later. So they were gaming the system. Price’s bill will not allow that.”