The ‘Trump effect’ on your Obamacare coverage

Happy Holidays from Medical Cost Advocate! As we enter a new year and new administration, change is inevitable on many fronts. Understandably people want to know what that means in regards to their healthcare. More specifically they want to know how they will be affected in light of the promised changes to Obamacare. Though we can only speculate at this point, a great overview by provides some insights based on what we know so far.

With our newly elected president threatening repeal of Obamacare, should you worry that your health insurance could go up in smoke?

By Louise Norris, contributor, November 12, 2016

Donald Trump will be our next president. What exactly does that mean for your health insurance coverage and access to healthcare? It’s a question that has drawn speculation from health policy wonks since the day after Trump’s election – but I’ve also been receiving many of these questions from clients who are curious about whether their coverage will change any time soon.

In truth, nobody can say for sure at this point, since there are still so many moving parts to the law. But we have some educated guesses, based on Trump’s positions and the actions Congress has taken over the last six years with regards to Obamacare.

Here are the best answers we have at the moment for some questions you might have, along with more details about what you can expect in the coming months and years:

Do you still need to buy ACA-compliant coverage?

Q: If Obamacare is going to be repealed, do I need to buy ACA-compliant coverage now?

A: Yes, you still need coverage for 2017, and now’s the time to buy it. On November 9, the day after Trump won the election, 100,000 people enrolled in coverage through, according to HHS Secretary Sylvia Burwell. That’s the largest number of sign-ups in a single day since open enrollment began on November 1, so there is considerable momentum in terms of people enrolling in coverage for 2017.

We can assume that Congress will pass legislation to repeal parts of the ACA (more details below), and that Trump will sign it into law. This is likely to happen in 2017. But it’s unlikely that it will have an effective date prior to 2019, as Congress will need time to implement its replacement plan, and the IRS will need time to establish the new tax system that will go along with whatever replaces the ACA (most likely, tax credits to offset the purchase of coverage).

So for 2017, you still need coverage. And subsidies — including premium subsidies and cost-sharing subsidies — are still available. Although they’re likely to be eliminated eventually, at least in their current form, that’s not likely to take effect in 2017. (more…)

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Americans don’t know what’s in Obamacare, do know they don’t like it

By Sarah Kliff, Washington Post

Fifty percent of Americans now say they oppose the Affordable Care Act. This is the highest number that Kaiser Family Foundation’s poll has seen since October 2011, when Republicans were in the midst of a primary cycle and lots of anti-Obamacare rhetoric was in the air. The easiest explanation for the recent upswing in negative sentiment would be that lots of Americans tried, but failed, to buy insurance through They ran into technical barriers that plagued the site in October and November. But Kaiser’s data don’t really bear out that thesis. There’s actually only been a tiny uptick in the number of Americans who say the health-care law has affected their lives over the past three months. A full 59 percent of Americans still report no personal experience with the law. 

Most Americans don’t know that Obamacare has, at this point, pretty much fully taken effect. When surveyed in January, after the insurance expansion began, 18 percent said they thought “all” or “most” provisions of the Affordable Care Act had been put into place.

There’s lots of confusion, too, about what policies are and aren’t part of the health-care law. Most Americans know there’s a mandate to purchase health insurance. A lot fewer are aware that the law provides financial help for low- to middle-income Americans (the tax subsidies) or gives states the option of expanding Medicaid.

For many Americans – particularly the 68 percent who get coverage through their work, Medicare and Medicaid — the launch of the exchanges probably doesn’t affect their coverage situation. They’ll continue getting insurance in 2014 just the same way they did in 2013. For them, an expansion of Medicaid or an end to the denial of coverage for people with pre-existing conditions isn’t a big change (unless, of course, they lose their current coverage).

So what’s driving the negative opinions of Obamacare? The Kaiser survey does point to one potential culprit: negative news coverage. More Americans say they’ve seen stories about people having bad experiences with the Affordable Care Act than good ones.

Politico’s David Nather had a great line on this recently, in a story about the very high bar for success stories about the Affordable Care Act.

“Here’s the challenge the White House faces in telling Obamacare success stories: Try to picture a headline that says, ‘Obamacare does what it’s supposed to do,’ ” Nather writes. “Somehow, the Obama administration and its allies will have to convince news outlets to run those kinds of stories — and to give the happy newly insured the same kind of attention as the outraged complainers whose health plans were canceled because of the law.”

We don’t have a great sense yet of what type of experience Obamacare’s new enrollees are having — whether they’re disproportionately bad or if the bad stories are just more interesting to cover. But the more negative news coverage does seem to have played some role in the recent uptick in negative opinions about the new law.

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