Every Idaho insurance carrier has lost, and continues to lose, millions of dollars in the individual health insurance market. These losses translate into much higher premium increases for Idahoans, higher out-of-pocket costs, reduced availability of health plans, and narrower provider networks. The individual insurance market simply is not sustainable as it now stands, and, if left unchanged, may force carriers out of our market.
The proposed replacement, the American Health Care Act, does not change the federal requirement that health insurance plans must cover pre-existing health conditions for everyone enrolled in the plan. Carriers cannot deny enrollment due to pre-existing conditions. All plans would continue to be guaranteed issue and guaranteed renewable.
While the future cannot be predicted with certainty, the likelihood is that health insurance premium amounts charged by insurance carriers would decrease if the Affordable Care Act is repealed and replaced. Prior to the Affordable Care Act, Idaho had some of the least expensive health insurance plans in the U.S., and, after a repeal, should once again have lower-cost plans. The proposed replacement plan includes tax credits that increase with age to help with paying premiums; however lowering the overall premiums charged is of paramount importance.
Idaho insurance law requires that newborn children, regardless of health condition, must be placed on their biological or adoptive parents’ health insurance from the moment of birth. Any and all health conditions experienced by the newborn must be covered.
Under the proposed American Health Care Act (AHCA), health insurance plans would continue to be guaranteed issue and guaranteed renewable, which means no one can be denied coverage or terminated if the premium is paid on time. Idahoans would continue to have the opportunity to enroll in health insurance coverage through an annual open enrollment period. Those who experience certain life changes, such as a job change or loss of previous coverage, would continue to be able to enroll outside the open enrollment period.
Under the current Affordable Care Act (Obamacare) rules, the oldest individuals enrolled in health insurance plans cannot be charged premiums that are more than three times higher than the premiums charged for the youngest adults. The proposed American Health Care Act (AHCA) gives states the option of allowing insurance carriers to charge the oldest enrollees premiums up to five times greater than those charged for the youngest enrollees. However, the AHCA also provides tax credits that increase with age, which would offer additional assistance to help older individuals pay premiums.
The AHCA prohibits insurance companies from charging less-healthy individuals more unless a state submits and receives a waiver to allow health status rating.
Concerning tax year 2017, the IRS is currently reviewing an Executive Order which directs government agencies to ease any burdens imposed by the ACA – at this point it appears individuals would continue to be subject to a tax penalty when filing their 2017 tax returns if there is a gap in coverage. Therefore, the best course of action is for Idahoans to maintain continuous health insurance coverage. The proposed American Health Care Act (AHCA) does not include the “individual mandate” provision of the Affordable Care Act (ACA), which subjects some uninsured individuals to a monetary penalty at the time they file their federal income tax returns. However, the AHCA provides for a 30% surcharge on the monthly premiums of those individuals who enroll in coverage after being previously uninsured.
Do you have a question about Health Insurance?
Submit your questions – our experts will respond with the facts.