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The proposed GOP healthcare plan and what it means for the ACA

Until Congress passes the proposed American Health Care Act, the current rules and regulation regarding the ACA remain in place. This means that the following aspects of the ACA must still be complied with for the duration.

Some of the rules and regulations that must still be followed include, but are not limited to:

  • Anti-discrimination rules related to transgender benefit protections and their enforcement
  • Individual and employer mandates and fines/taxes for non-compliance
  • Market reform mandates and IRS tax enforcement from large employers whose self-insured group plans do not satisfy market reform rules
  • Reporting obligations/IRS tax enforcement of dues from large companies failing to accurately and in a timely manner report coverage offered to workers/dependents

The rising opposition to the proposed American Health Care Act, is likely going to cause a delay in the ability for the Act to pass through the House and Senate. Many voices of opposition are voicing their concerns that rushing through this healthcare act and not allowing it to be properly vetted will have the potential to adversely affect many Americans.

The next few months or years are likely to be confusing and frustrating. Insurance agents, brokers and carriers are going to be doing their best to stay on top of the latest changes.

Posted on Friday, March 31st, 2017. Filed under Health Insurance.

How the executive order affects larger employers?

Late January, President Trump signed a healthcare executive order that could impact employers, even if it did not specifically mention them.

The executive order instructed federal agencies to, “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement that would impose a fiscal burden,” on states, health care providers or individuals. The order can undo individual mandates to purchase insurance and other mandates placed on employers, like providing full-time employees with coverage.

The employer mandates may be regarded as a fiscal burden, according to the wording of the executive order. The employer mandate may become questionable if there is no tax on individuals who do not have minimum essential health insurance.

Nonetheless, it is advisable for all employers to continue complying with the established rules by the ACA until the GOP proposed American Health Care Act (or another act) is implemented.

The transition from the ACA to the proposed American Healthcare Act may be painful and prolonged. Stay on top of what is happening in the industry and understand your existing health coverage to be able to evaluate what may replace it.

Posted on Monday, March 27th, 2017. Filed under Health Insurance.

How does the executive order affect current guidance in relation to the ACA?

Late January, President Trump signed an executive order that urges his administration to repeal and replace the Affordable Care Act (ACA). The order allows legislators to fight the current health care system by adding new rules and regulations. The executive order points the administration to allow states to decide the changes in healthcare policy.

This order sends a signal to the American people that health care laws are coming. The order itself, however, does not affect the ACA directly. In fact, the executive order is broad in scope and it raises a number of questions such as:

  • How will changes impact employers offering group health care plans?
  • How does the order affect what is currently in place under the ACA rules and regulations?
  • If the mandate for individuals to have minimum essential health insurance or pay a penalty is suspended, how does that affect employers?

With so many questions to be answered, the plan to replace ACA is not going to be immediate. Given the nature of the legislative process, checks and balances, public input on various issues, various legal issues and political agendas, it may be several years before the ACA is replaced.

Posted on Friday, March 24th, 2017. Filed under Health Insurance.

What did the executive order to repeal the ACA outline?

President Trump and his administration are actively engaged in negotiations about legislation meant to repeal and replace the Affordable Care Act (ACA). In late January, Trump signed an executive order that urges the current administration to fight the ACA.

In order to try and understand the executive order, here is a quick look at what the order contains:

  • The new administration’s policy is to seek a prompt repeal of the ACA
  • The order intends to efficiently maintain the ACA until repeal efforts are concluded
  • The order minimizes regulatory and economic burdens to the states
  • The order provides the states with greater flexibility to implement a free marketplace in the health care insurance industry

The full text of the order is far more revealing and it directs the Secretary of the Department of Health and Human Services (HHS) and other agencies with authority under the ACA to: “exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the [ACA] that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.”

It is clear that Trump intends to follow up on his campaign promise, and repeal and replace the ACA. In the months and years to come, a number of significant changes to the health care industry are expected. How this will impact on consumers is another question. Therefore, it is advisable that you check your existing health care insurance, understand fully what it covers and when any changes will be made to your coverage. Staying current on any healthcare news will allow you to transition into the future health care plan with ease.

Posted on Wednesday, March 22nd, 2017. Filed under Health Insurance.

Three Part Legislative Steps Required to Repeal the ACA

One of the first executive orders President Trump signed was to pave the way for Congress to repeal and replace the Affordable Care Act (ACA). That order came one week after the House of Representatives passed a Senate budget resolution bill opening the door for the first step in a three step process to repeal the ACA.

A “reconciliation directive” in the budget resolution bill instructs four committees that oversee the federal healthcare program to draft legislation to repeal the ACA. The four committees involved include: the Energy and Commerce Committee in the House; the Health, Education, Labor and Pensions Committee in the Senate; the Finance Committee and the Ways and Means Committee.

The resolution bill gave instructions to complete a draft of repeal legislation by January 27, 2017. This deadline was unrealistic, as discussion about which parts of the ACA to repeal took more than only a couple of weeks. It is not clear what parts of the ACA, if any, are to be preserved.

The next step in the complete repeal and replacement of the ACA, is for the four committees to send their plan, also known as budget reconciliation, to the budget committee. Following this, both houses of Congress will take a vote, and a simple majority is necessary for the reconciliation to pass. Only after the vote, will parts of the ACA be repealed.

The last step in the process of ACA repeal and replacement is a comprehensive healthcare plan to replace the ACA. Following the release of the American Health Care Act, the Republican plan to replace and repeal the ACA a debate erupted between the Democrats and Republicans regarding the protection of coverage for low-income people.

The growing opposition to the proposed Republican healthcare program will likely affect the timeline of the repeal and replacement of the ACA.

Posted on Monday, March 20th, 2017. Filed under Health Insurance.

What is not covered by Medicare Part A and Part B?

Medicare Part A and Part B does not cover every medical procedure. If you find that some of the services you need are not covered under Medicare, you will need to cover the remainder yourself. If you have supplemental insurance or additional Medicare plans, they may offer the necessary coverage.

Medicare Part A and Part B cover hospital stays, outpatient care, medical supplies and more. However, even if Medicare Part A and Part B covers medical procedures, the plans still require a co-payment, a deductible or co-insurance.

Some of the services that Medicare Part A and Part B do not cover are:

  • Routine foot care
  • Hearing aids
  • Exams for fitting hearing aids
  • Eye exams for prescribing glasses
  • Dentures
  • Long-term care/custodial care
  • Cosmetic surgery
  • Acupuncture
  • Most dental care
  • Treatment not medically necessary
  • Vaccinations/Immunizations
  • Prescription drugs taken at home
  • Non-prescription drugs
Posted on Friday, March 17th, 2017. Filed under Medicare.