May 2018 Healthcare Forum

The Affordable Care Act (ACA) – Still Alive and Well

This month we’ll discuss the current status of the Affordable Care Act, how it was weakened by the Republican December 2017 tax law, and what you can do to obtain high quality healthcare without depleting your savings.

The good news about the ACA is that the number of Americans who obtained insurance through the Obamacare health exchanges for 2018 was 8.8 million, just 4.5% less than the 9.2 million who obtained insurance in 2017.

Thanks to the ACA, you can’t be denied insurance because of preexisting illnesses; there’s no longer a cap (limit) on yearly and lifetime benefits; and ACA-approved policies must include essential medical benefits (including treatment of mental and substance abuse disorders). Also 32 states and Washington D.C. have expanded their Medicaid program, making it easier to get Medicaid coverage. (Medicaid has accounted for more than 50% of newly insured Americans).

How Trump’s December 2017 Tax Law Injured the ACA

  1. The tax penalty for going without health insurance ends next year (2019).
  2. More young, healthy Americans will join the ranks of the uninsured (estimated to reach 17 million by 2027), raising the cost of insurance still higher (probably more than 10% per year), especially for those between ages 50-64 and the self-employed.
  3. Even Americans with insurance, especially those with high deductibles, will delay getting medical care, increasing their vulnerability to illness.

Strategies to Get Quality, Affordable Healthcare Despite the Trump Agenda

  1. To reduce your cost for health insurance, consider a plan with a higher yearly deductible.
  2. You may be eligible for a Health Savings Plan (HSA) where contributions are tax deductible (possibly lowering your federal and state tax). Monies can be withdrawn tax free to pay out-of-pocket medical costs. Granted, most of us just try to make ends meet, but contributing just $50 or more per month may come in handy and sets a good example for others.
  3. An alternative is to put some money into a Flexible Savings Account (FSA). If employed, most big companies can assist.
  4. If you and family members (with your doctor’s advice) can delay having expensive medical care (e.g., hip replacement) for a year or two and then have all this postponed medical care early the next year, you may be able to satisfy your deductible, so subsequent medical care may cost (depending on your policy), only a 20% copay. And, if you’ve reached your maximum out-of-pocket costs for the year, your subsequent costs may be considerably less.
  5. If you and your family decide (for financial or other reasons) to go without insurance, enroll now at a neighborhood free or low cost medical clinic, a University medical center, or if you served in the Armed Forces, you may be eligible for care at a Veteran’s Administration (VA) health center. With more Americans opting to go without insurance, these medical centers may be overwhelmed with patients.
  6. Before changing jobs, factor in the insurance benefits provided by a prospective new employer. If you’re considering becoming self-employed and need health insurance, consider what may be the very high cost of individual or family insurance. If you want to keep your current doctor(s) and specialists, make sure these physicians have contracts (are “in-network”) with your insurer (call your doctor’s office rather than relying on outdated information on the Internet).
  7. If your income is low, find out if you qualify for a federal subsidy.

We welcome your questions about today’s forum. Please leave any questions or comments below. We cannot answer questions about your personal medical problems because of medical-legal restrictions and because they are best addressed by your doctor.

If you have family members or friends you think may benefit from this forum, please forward it on to them. If they would like to receive our monthly forum, they can sign up for our mailing list below.

For June’s Forum, we’ll discuss Getting Quality Healthcare and Insurance Without Depleting Your Savings.

The title of our book to be published in 2019 is “Doctors’ Inside Guide to Quality Affordable Healthcare.” Watch here for updates about the book.

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