The real looming threat is the loss of health plans participating in the IFP market. In 2017 three carriers dominated the market with 72% of the enrollments: Anthem Blue Cross 19%, Blue Shield 25%, Kaiser 28%. With the loss of Blue Cross in the major metropolitan markets such as the Bay Area and Southern California, two carriers, Blue Shield and Kaiser, are likely to command over 60% of the market place in 2018. If one of those two carriers determines that offering IFP plans is just too risky in 2018, it could lead to other carriers such as Health Net, Molina, or Oscar also pulling out of the market.
The real story is that rates, especially for older people, have risen so much in the individual and family market that health insurance under the IRS definition of being unaffordable can happen at a very young age. Below are examples of the least expensive Bronze plan rates in Region 1 and Region 3. Within a thirty minute drive between Auburn (Region 3) and Grass Valley (Region 1) in Northern California the rates can be sharply higher.
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.
Anyone who did not have health insurance for a period of more than three months during 2014 will have to pay a penalty on their IRS federal tax return. This penalty is also known as Affordable Care Act Shared Responsibility Payment. The ACA has given taxpayers who went without having health insurance for a period during […]
The Individual Mandate of the Affordable Care Act psychologically chafes folks who don’t appreciate the government telling them what they have to purchase. Count me in that segment. If one of the goals of the Individual Mandate is to make people take responsibility for expensive health care, an alternative might be an unforgivable tax liability on those people who have chosen to forego health insurance and incur large medical expanses that go unpaid.
What the study spot lights is that a small percentage of the U.S. population (approximately 7%) will actually have to purchase health purchase coverage because they currently have no coverage.
Don’t like the individual mandate of health care reform? Just promise to pay your bills.