Widespread changes to the health care landscape are still occurring in the United States, even if they haven’t received much media attention lately.
The Affordable Care Act (ACA) was established as a law in 2010 by President Barrack Obama. However, health care reform is now under the direction of President Donald Trump—and could have an impact on your business in 2019 and beyond. The three biggest ACA changes to be aware of include:
- There will be no federal requirement for individuals to either buy health insurance or pay a tax penalty.
- More states will be able to create reinsurance programs—to reimburse insurers who cover high-cost claims—partially funded by the U.S. government.
- New “short-term insurance plans” that offer the bare minimum coverage, but are not (currently) ACA compliant, will be offered.
Here is everything you need to know about these planned changes to the ACA, as well as answers to common questions regarding how organizations should approach the updates.
ACA Changes Explained
For many individuals, the most welcome change has to do with removing the tax penalty that was previously imposed on those who refused to purchase ACA-compliant health care plans. This could save consumers who choose to pay for their health care needs using other methods as much as 2.5 percent of annual household income, or $695 per person. It’s important to note, however, employers are still required to follow the guidelines of the ACA when offering insurance to employees.
“President Trump is urging federal regulators to ease restrictions on the sale of the plans, which could let insurers sell ‘short-term’ policies lasting up to 364 days,” Consumer Reports notes.
Short-term ACA plans will give more employers a choice over what benefits they choose to pay for, and provide less expensive options for individuals. This is part of the ACA change that Trump is pushing for; encouraging more states to take over control of health care mandates. Because these plans cover just the bare minimum in health care—leaving out dental insurance benefits, pregnancy and childbirth coverage—premiums are much cheaper than traditional ACA health insurance plans.
An additional ACA change is allowing reinsurance with an initial $5 billion cap. Mark A. Hall, director of the Health Law and Policy Program at Wake Forest University’s School of Law, explains, “This federally prescribed program will identify high-risk subscribers based on a list of 50–100 expensive conditions and pay scheduled amounts to insurers to offset their expected costs.” This is expected to reduce premiums by as much as 20 percent in the 2019 benefit season.
Will Organizations Have to Make Big Changes to Their Health Insurance Plans?
Organizations will be tasked with reviewing their health insurance plans to make sure they are still in compliance with ACA guidelines. For the time being, only a few states have been approved for the short-term ACA plans.
Will Changes Be Made to Dental Insurance Benefits?
In terms of dental insurance benefits, employers can still offer them and also direct employees toward low-cost alternatives for obtaining good oral hygiene. Education is always important, therefore employers can do their part by encouraging employees to regularly visit their dentist of choice for preventive care.
How Should the ACA Changes Be Communicated to All Employees?
Benefit communication for the 2019 plan year will take some extra effort so that all employees understand how the changes may impact them. It’s recommended that employers create both written materials and verbal explanations that can be used to speak with employees about their options during open enrollment season. This includes information about the various dental insurance benefits and supplemental benefits they may be able to obtain at a low cost as part of the employer group. Additionally, benefit administrators should be available to answer individual questions.
Looking for a new dental benefits plan for your company? Take a look at United Concordia Dental’s website and explore the different offerings that best suit your (and your colleague’s) needs.