First Step Towards Replacing Obamacare

By: Rory P. O’Brien, RPO Group Benefits + Consulting

After many weeks of debate, last week the House of Representatives passed what is known as the American Health Care Act (AHCA). Next up, it will be put forth in front of the Senate for a vote.

Two topics which will be certain to get a lot of discussion and disagreement will be related to Medicaid and Pre-Existing Conditions. Under Obamacare, there have been an additional 16.7 million newly enrolled in the program. That represents a substantial majority of the total Americans who obtain their coverage under that act.

The new law as is currently worded, would roll back federal funding for this expansion, and introduce limits on federal Medicaid spending for the states. The House and the Senate will ultimately have to come to some agreement on this major area of concern.

Additionally, there is much confusion as to what extent the people with Pre-Existing Conditions will continue to be protected. It appears as though protections remain in place, just within different boundaries. This will have to be clarified to the satisfaction of the Senate. Undoubtedly, there will be strong resistance from the Democratic side of the Senate, similar to that which took place in the House.

Something must be done with the healthcare system in this country. Almost everyone agrees with that. It is a shame that all our representatives cannot find it within themselves to work together toward what should be the ultimate goal of a quality system that works for everyone.

Age 26 Provision Survives

By: Rory P. O’Brien, RPO Group Benefits + Consulting

To the delight of many, the new healthcare bill (AHCA)which was recently passed in the House, preserves the highly popular age 26 provision. I understand the popularity, but this feature is almost certain to doom, or at least significantly impact the desired results of the new plan, similar to its impact to Obamacare. The way it currently stands, the child who is 25 years old, great job, married with children of their own, and living in a different state can stay on their parent’s plan. Does this make sense?

In order for any plan design to be financially successful, it must have the inclusion and participation of the young and healthy. Yet, instead of incentivizing them to participate, this provision gives them no reason to even consider it. It’s as if the plan was designed by 2 different architects, with different considerations in mind.

The initial introduction of this concept came when the recession hit. It was to recognize and respond to the concern that newly college graduates could not find jobs…..and thus were left without healthcare coverage. So its purpose was well intentioned at that time. However, in my opinion, I think it should have been introduced with a “sunset” clause which expired upon the opening of the Healthcare Exchange. The Exchange would have provided access to coverage, while at the same time offering financial subsidies if there were still no jobs, or little income.

Now, here it is again. A more realistic design would be to make insurance available to only those under age 26 people who do not have employer/workplace coverage offered to them.