Health Insurance 2019: What’s changed and what has not Kevin O’Connor San Juan Basin Public Health

Questions?

What has not changed Insurance Carriers: Anthem and Friday Tax credits to help pay premiums, rates will go down for many people Cost Sharing Reductions are still available Assistance is still available from Brokers, Health Coverage Guides, and Certified Application Counselors Open Enrollment Period: 11/1/2018 to 1/15/2019

What has changed La Plata Family Centers Coalition and Pinion Project in Cortez will not be providing enrollment assistance Funding for Health Coverage Guides down 20% (going down additional 20% in 2020) Simplified financial application system for Connect for Health Colorado No Shared Responsibility Payment (aka tax penalty for not having a Qualified Health Plan)

What has changed, cont’d: Short term policies extended to 364 days by Federal law Association plans allowed and expanded by Federal law State law is not over-ruled, Colorado has more limits so far New short term and association plans have not been created yet Brokers are allowed (but not required) to charge fees

Short Term policies The Good The Bad Usually significantly lower premium than Qualified Health Plans through Connect for Health Colorado Not eligible for tax credits Subject to underwriting Policy ends after 6 months, not renewable but you can reapply one time Preventive care not always covered 100% Limitations and exclusions Payout limits Right of rescission

Don’t take my word for it “Short-term plans are cheap for a reason - they typically exclude pre-existing conditions that people have and they can cap the amount of coverage they provide,” said Colorado Insurance Commissioner Michael Conway. “Because many people will need more coverage than these plans offer, what consumers end up paying out of their own pocket could easily surpass any savings from low premiums.”

Association Plans The Good The Bad Sometimes significantly lower premium than Qualified Health Plans “Associations” has a broad definition, which increases availability Not eligible for tax credits Not everyone will have access Subject to underwriting Preventive care may be limited Limitations and exclusions Payout limits Right of rescission

Don’t take my word for it The need for more affordable coverage is real, but there are plenty of reasons to be wary of association policies. Their dismal track record through the years hardly suggests they’re a cure for our insurance system’s ills. Their return signals a resurrection of the Dark Ages in American health insurance and that old consumer warning, “buyer beware.” Trudy Lieberman, Center for Health Journalism.

What does it all mean? End of tax penalty expected to have relatively little effect Short term plans still are not a solution to high rates Association plans will be a mixed blessing at best Brokers’ fees are still an unknown factor Despite funding cuts SJBPH will provide help as always APTC changes means people on basic plans may pay less and Gold plans may be a better choice than Silver for some