Fasten Your Seat Belt for the Health Care Ride
More choices, lower prices — these and other changes are ahead for consumers as 'repeal and replace' work begins
At the top of Donald Trump’s White House priority list is a better and stronger health care system at a more affordable price for Americans. There are many questions as to what will change, how it will change, and how American households of all sizes and shapes will be affected.
As the Trump transition team and others work on a viable plan to repeal and replace the Affordable Care Act, how might the average health care consumer prepare for the years ahead?
Many experts take the long view. “Nothing is really going to happen until as early as 2019 as far as changes to the [health care] system,” according to Paul Moyer, author of SavingFreak.com and licensed insurance agent in Anderson, South Carolina. Moyer explains it takes a lot of legislation, which is often then delayed, to turn the tide of one of the country’s biggest industries.
Cardiologist Dr. Ramin Oskoui, who is CEO of Foxhall Cardiology PC and a regular contributor to LifeZette, agreed with that assessment. In general, he said, things move slowly and change will take time.
Oskoui also added this urgent note: “The prices you pay for drugs and doctors visits are going to continue to go up more. That is not good for most people who have finite financial resources. Among actual practitioners and hospitals, their profit margins are getting squeezed and their net income is getting dropped substantially. They’re having to make reductions in staffing and other areas where they can make as much money as possible, but rural hospitals are in pain and are closing. It’s going to be more of the same, and the ‘same’ isn’t good,” he told LifeZette.
After that, the everyday consumer should expect to see more insurance choices on the horizon, possible drops in cost, more tailored health care plans, and perhaps even a decrease in health care spending overall. Let’s examine some of these in detail.
More Insurance Choices for Your Buck
Paul Moyer lives in a county with only one choice of health insurance right now — all the other companies suffered losses that were too great. “The ACA is why Tyler, Texas, like hundreds of other counties nationally, has only one carrier selling health insurance,” explained Dr. Deane Waldman, director of the Center for Health Care Policy at the Texas Public Policy Foundation, in Austin, Texas. Waldman said in an email that the company in Tyler, Texas, raised its rates 60 percent this year. So most consumers are faced with a catch-22 choice: “Pay a price they cannot possibly afford, or go without insurance coverage.” A repeal and replace of Obamacare could mean more choices for those people in counties with limited coverage.
More competition means more choices means cheaper premiums — that’s capitalism at work.
Rebate Instead of Mandate
The Obamacare mandate restricted civil liberties in a lot of people’s eyes. Right now, Republicans are considering many different versions of the repeal and replace process, but almost all replace the individual mandate to buy health insurance with a tax rebate for choosing to purchase it. Health insurance — though important — still comes as a lower priority than rent, utilities, and food. People can get help through the Medicaid system, and those who don’t want insurance can choose to forgo the option once more.
Cheaper Primary Care Options
Some of the things driving up health care costs are unnecessary emergency room visits, malpractice insurance, and pricey primary care, Moyer explained. The GOP-led legislation might “encourage more things like nurse practitioners and physician assistants, who wouldn’t charge as much as a doctor but could still provide good primary care,” Moyer told LifeZette. More affordable primary care may decrease the number of unnecessary ER visits, which drive up the cost of insurance for everyone.
Tailored Health Plans, Not ‘One Size Fits All’
“One of the reasons Obamacare is so expensive is that it mandates so many things be covered by the insurance,” Moyer said. For example: He and his wife have three young children, and they’re not planning on any more; they’ve opted for permanent birth control. Yet their plan still includes birth control, even though it’s coverage they don’t need. Their plan also covers abortion. “My family is religiously opposed to abortion, so we’re never going to get an abortion. We shouldn’t have to pay for a plan that has abortion coverage in it.”
Some Reforms Will Remain
Coverage for people with pre-existing conditions, and young people remaining on their parents’ insurance plans until age 26 — these two popular reforms will likely remain in whatever new legislation emerges. Trump himself has said that. “There’s just not a normal market solution where you have someone who has a chronic disease,” Moyer said. “No insurance company is going to pick them up for the same price, because the ongoing care for them is going to run more and more as time goes on. So there’s a place for government in there for that reason. It doesn’t look like they’re going to repeal those kinds of things.”
Work in the Present, Get Help When Needed, Don’t Worry Too Much
“It’s easy to complain — and I’m no fan of Obamacare myself — but when it comes to actually presenting a better solution, that’s the hard part,” said Joel Ohman, a certified financial planner and founder of the website MedicareInsurance.com, in Tampa, Florida. “The best advice for patients is to deal with things the way they are, not as they hope them to be. As always, work with a knowledgeable independent insurance agent who can help you compare options from multiple companies and make a decision that is best for you.”