ACA or bust?


Posted on January 30th, by Kimberly Patterson in Business and Workplace. 2 comments

 Affordable-Care-Act1

As the Affordable Care Act continues to unfold, we may also see it flop if enrollment numbers don’t change. Based on research performed by HHS (Health and Human Services), many uninsured Americans were young people.  With that knowledge, Kathleen Sebelius, the HHS Secretary, assured insurance carriers that they would have at least a 40% enrollment of young (between the ages of 18 and 24) subscribers into the ACA.   As a result, the insurance carriers formulated their rates within the ACA exchanges to insure this low risk demographic group.  All of the research shows that in order to keep the premiums stable and to prevent carriers from leaving the scene altogether, roughly two in five Americans enrolled need to be young adults.

As of writing this post, there is a 24% enrollment of young folks in the ACA.  Not what carriers were expecting. One-third of the enrollments are in the 55 to 64 age group.  Open Enrollment ends on March 31 so we’ll know more when the final enrollment numbers are published.

So while folks enrolled in the exchanges might be getting an affordable health plan this year, I certainly hope they’re following this because there is nothing stopping insurance carriers from raising their rates for next year or even bailing from the exchange.  What then?  Affordable healthcare under the government will no longer be affordable and we’re back to the drawing board.     

Enroll or be fined

It may hit your wallet if you can’t prove that you have medical insurance.   You may have heard about this under the guise, “Individual Mandate“.  This fine isn’t anything to sneeze at — the breakdown of the fines for each year is on this awesomely informative site.  And don’t try to lie about having health insurance or you’re looking at a $25,000 fine.

The death of non-group plans

There was a time when you could buy a non-group (not dependent on an employer) health insurance policy that was affordable. Perhaps it was a high-deductible plan with hospitalization coverage — you could self-insure your doctor visits by paying out of pocket.  This was a good way for self-employed folks to have affordable health insurance.  Those plans are gone.  The ACA has put restrictions on the types of plans that are offered in the non-group market.  Hence the health insurance cancellations we’ve been hearing about.

I haven’t even touched on the impact it’s going to have on small businesses and, unfortunately, I could fill an entire page on that topic alone. 

I’m not sold on how the ACA will help our healthcare situation and I think it’s going to further hurt the economy with the fines to individuals and businesses.  I hope I’m wrong. 

What really stumps me is how we’re supposed to believe that a government program backed by for-profit insurance companies would ultimately provide anything affordable for Americans?  

Bring it.





2 thoughts on “ACA or bust?

  1. Kimberly,

    I completely agree. Our open enrollment was 11/01/13, and we had increases, a small portion of which we passed through to our employees. Then, effective 01/01/14, the “Health Insurer and Reinsurance Fees” fees were charged to BCBS, who of course passed them on to us, a non-profit substance abuse treatment organization. Anywhere from $15 – $48 more per month. We know that many of our employees are maxed on what they are already spending on healthcare. So we are NOT passing along this increase to our employees, and it will be a hit to our bottom line of $24k. Just one example of how it is negatively impacting business, and as you stated, there could be a full page on that topic alone. Thank you for the additional information.

    • Hi there Kellee,
      wow, $24K is surely a big hit. Not sure what size your company is but have you also noticed a change in the premium tiers? Most group plans all had the same rate for single, ee + 1, family, etc. Now, I’m seeing group plans with the employee premiums based on age. It will be interesting to see how companies will be handling that one as well.

      Thanks for your comment and good luck.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>