Experts: ACA changes to hurt consumers in 2018

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Consumers will be hurt by the Trump administration’s moves to change the Affordable Care Act (ACA), experts tell us. The only questions are by how much and whether that will change in the years ahead.

Frustrated by the inability of Congress to repeal and replace the health-insurance law, President Donald Trump launched a two-prong attack. First, he issued an executive order that directs three government departments to make rules that open up insurance markets across state lines, extend short-term limited-duration insurance and make health-expense-reimbursement arrangements more available to employers.

Second, Trump announced that he was ending payments to health insurers that amount to subsidies, so low-income people are able to buy health insurance on discount.

Two experts tell Consumers Digest that the latter action will be the one that’s felt right away by consumers, and it won’t be good. Consumers who buy their health insurance through the open market will see their premiums increase significantly in 2018 when the enrollment period opens Nov. 1, 2017. How much that increase will be depends on circumstances, says Laura Adams of Insurancequotes.com.

“It kind of depends on where consumers live, but it could be anywhere from single digits to 20 percent or even more,” she says.

Eighteen states and District of Columbia sued the Trump administration to maintain the subsidies, but even if the legal action were to move quickly, it likely won’t affect 2018 rates. Adams explains that insurers had to file their 2018 premium rates in spring 2017, and it was well-known then that Trump might end subsidies at some point. She says insurers typically provided two rates—the rate if subsides existed and the rate if subsidies didn’t.

“Presumably, the policies without [the subsidies] would go into effect immediately,” says Timothy Jost, who is a health-care-law expert at Washington and Lee University.

Even if legal action were to favor the states that are suing the federal government, it wouldn’t affect rates until 2019, Adams says.

What’s less known is how the executive order will affect consumers, because it calls only for rules to be made, not for actual policies, although the Trump administration made clear what direction it wants the rules to take. The rules aren’t expected to be completed and announced until 2018. It’s uncertain when they’d take effect.

“Until the rules go into effect, there’s no chance for anyone to challenge them,” Jost says.

If enacted as the Trump administration wants, the rules would be a mixed bag for consumers, Adams says. Extending the short-term policies and opening the market to multistate associations would increase the number of insurance choices for consumers, particularly consumers who want a lower cost plan that doesn’t cover everything.

Of course, having more choice is good, and having low-cost insurance is better, but Adams points out that lower cost plans will have limits that don’t adhere to ACA mandates that require minimum coverage. Consequently, consumers will have to do their own due diligence with respect to knowing the limits that their health insurance has—the way it used to be before the ACA existed.

“[Consumers] are not very good at interpreting insurance plans,” she says. “They’re written by lawyers for lawyers. They’re very complicated, and the lingo and language could be very confusing.

“People might say, ‘I just want the cheapest plan,’ and they may find out later they’re not covered. That’s the risk.”