New Ammendments Undermining The ACA

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November 20th, 2013

ACAThe latest chaos to emerge from the healthcare reform rollout has left most of America thinking one thing – is this all even worth it?

In the past few months many of the ACA’s key components have come under scrutiny from all corners of the healthcare industry. Following the disastrous rollout of the online health insurance exchanges and a number of delays to key mandates within the law, further changes to the ACA now include the extension of cancelled insurance plans into 2014 & 2015 and the option to purchase coverage directly through insurers and brokers.

Problems Create More Problems

The extension of cancelled insurance plans was prompted by the public outcry following many individuals receiving letters that they could no longer keep their current coverage due to it’s failure to meet coverage requirements – something that was promised would not occur. The amendment was then met with even more criticism, specifically from insurers who would now be forced into renewing hundreds of thousands of plans and restructuring their systems in time to meet the December 15th deadline.

While the option to allow these extensions has been deemed dependendant on the choice of state insurance commissioners and insurance companies, it’s a measure taken by the administration that could undermine many of the foundations within the ACA. Individuals whose coverage will be reinstated will cause a dramatic shift in the risk adjustment pools used to project premium prices by insurers. Many inadequate and cheaper plans will now remain in existence for 1 to 2 more years, leaving newer insurers to the market in a position where they cannot compete price-wise. The majority of these plans cover healthier, younger individuals, whom were pinpointed as the key to carry the ACA and its provisions forward.

Patrick Johnston, the chief executive of the California Association of Health Plans spoke on the effect this may have. “The entire underlying premise of the ACA – balancing costs of the young, old, sick and health – has been left adrift.”

The combination of both extending cancelled policies and the failures of Healthcare.gov then prompted the administration to allow individuals to purchase coverage directly, bypassing the health insurance exchanges entirely.

Is There A Solution?

So, at this point the healthcare reform law is beginning to lose its distinguishing demeanor and is looking more and more like the healthcare industry of yesteryear – at least until 2015.

While many are still calling for the law to be repealed in its entirety, the sick and elderly remain firm supporters and have been the only group to actually persist through all of the ACA’s problems.

For now, the healthcare landscape has been left in a state of limbo, where some individuals will receive coverage through the intended format under the reform, whilst the young and healthy remain happy with their sub-par, cheaper coverage and no longer have to worry about dealing with technical glitches that accompany HealthCare.gov.

Unfortunately, the solution to these problems may only cause more chaos. Should the current administration delay the entire ACA law for 1 or 2 years until they are able to iron out the wrinkles? Can they afford to? Or should the law be scratched completely opening up a free marketplace for insurers to compete in?

One thing remains certain; the ACA will continue to unravel if more changes, delays or temporary fixes are implemented.

Feel free to voice your opinions by commenting below or join the discussion by following us on Twitter at @payerfusion.


One Comment

  • Lynn says:

    You state sub par insurance plans. What do you base that opinion on? Many insurance plans are tailored to an individual's needs not necessarily a scripted list made by some bureaucrat. If the plan meets the individuals needs then it is not sub-par. That is why it is a marketplace. If you can only take one of 4 plans and they are all the same, that is not a marketplace. Most of those 4 plans in my opinion are sub-par. The deductibles and out of pocket expenses are enormous. Most patients unless they have a catastrophic incident will never meet that deductible in a year. Thereby rendering the new Obamacare plan sub-par because it puts all the expenses on the person's out of pocket. If they couldn't afford insurance before and now they have to pay the insurance plus pay the deductible, copay and co-insurance, I venture to say you're going to see a lot of people not seeing the doctor very often. If you look at the plans the deductible and the co-pay are not subject to the out of pocket max. So if you pick a bronze plan with a $5000 deductible and a $50 copay neither of which is subject to the OOP. You're talking about approximately $12,000 out of pocket before the plan even pays anything. How do you call that affordable or even a good plan?