The similarities between Medicare Advantage plan and the ACA plans through the Marketplace are straight forward. Individuals are enrolling in private ACA health insurance and the federal government is subsidizing part of the cost of the health insurance to make it affordable. One of the main differences is how the federal government reimburses the insurer. Medicare beneficiaries receive an indirect subsidy to purchase a Medicare Advantage plan according to county they live in and based on historical health care cost data. Individuals and families enrolling in a health plan through an Affordable Care Act exchange receive a subsidy based on their income.
HHS has already launched a new page aimed at touting their latest attempts to revise the Affordable Care Act. Providing Relief Right Now for Patients links to initiatives HHS hatchet man Price has started to improve (gut) the ACA. The page states, “We are going through every page of regulations and guidance related to the Affordable Care Act to determine whether or not they work for patients and whether or not they are making our health care system better.”
Under Secretary Price’s proposed rule, a health insurance company could deny coverage during the open enrollment period if the consumer had a health plan through the company in the prior year, but let the coverage lapse for non-payment. Before the consumer could enroll in the plan, the insurance company could demand payment for those months after the plan was terminated for non-payment.
Since the beginning of health care reform under President Obama there has been intense speculation about how the health insurance companies will react when setting rates for the various health plans they offer. Health insurance is not a commodity like wheat, oil, or pork bellies where the market place of buyers and sellers agree upon a price. While competition does impact the rates to a certain degree, health insurance prices are largely determined by the health care services to be covered, the cost of health care services, and the expected claims for those services within a geographical location where the plan is being offered.
A Texas U.S. District Court Judge ordered the Department of Health and Human Services (HHS) not to enforce rules against discriminating against transgender health care services in health insurance policies. The order was issued on December 31, 2016 before the new nondiscrimination rules were set to go into effect. The nondiscrimination rules are part of Section 1557, the nondiscrimination provision of the Affordable Care Act (ACA). A lawsuit brought by The Becket Fund for Religious Liberty
Under an Executive order signed by President Trump on January 20, 2017, he gave federal bureaucracies the discretion and authority to waive any provision of the Affordable Care Act that might impose a fiscal burden on individuals and families. Two of the most prominent fiscal burdens are the repayment of excess Advance Premium Tax Credits and the Shared Responsibility Payment also known as the individual mandate penalty for not having health insurance.