Is Obamacare here to stay?: 3 Things to Expect in 2018

The Affordable Care Act, also known as Obamacare, enables millions of Americans to access preventative and curative healthcare services by providing them affordable health insurance.  Obamacare is one of the Obama Administration’s defining achievements; yet, since the end of Obama’s term less than a year ago, the GOP has worked tirelessly to disassemble the program and to unravel the standard of universal healthcare access that Obama prioritized during his tenure as President.  Despite their efforts and actions to repeal Obamacare, the GOP did not have the sweeping success they had anticipated for 2017.

As the new year begins, let’s take a look at the current state of the Affordable Care Act and how it will affect patients and providers in 2018.

1. Goodbye, individual mandate.

The GOP’s recent tax reform legislation – signed into law by President Trump –eliminated the individual mandate, which was the element of the ACA which required Americans to either buy health insurance or pay a fine.  Touting the success of the GOP and the elimination of the individual mandate, President Trump was quick to declare that the end of the individual mandate signaled the end of Obamacare.  The individual mandate was a hallmark reform of Obamacare, as it required most Americans to purchase and maintain a minimum level of health insurance, leading to millions more insured adults.  However, even with the individual mandate repealed, the Washington Post reports that “other central features of the ACA remain intact — including its insurance marketplaces, the federal subsidies that pay premiums; and the expansion of Medicaid.”

2. Diminishing rates of insured healthy adults.

Obamacare’s individual mandate is what makes health insurance affordable to most Americans – by requiring all adults to purchase health insurance, healthy consumers’ premiums are used to pay for sick consumers’ healthcare expenses. When given the choice to not purchase insurance, many healthy Americans are expected to opt out of the program, as they don’t foresee a need for health insurance in the immediate future.  As healthy enrollees withdraw from their insurance plans, healthcare premiums will rise for the remaining insured persons – many of whom are those most in need of expensive medical care.  The Congressional Budget Office anticipates steadily rising healthcare premiums will accompany these rapidly diminishing rates of insured Americans. In November, the CBO announced that the repeal of the individual mandate is estimated to decrease the number of insured Americans by 4 million in 2019 and by 13 million in 2027.

3. The ACA is here to stay.

The GOP is split as to whether it’s time to abandon plans for an ACA repeal. Senate Majority Leader Mitch McConnell has promised that the GOP will seek greater bipartisanship in 2018, and he seems satisfied that the recent tax plan sufficiently guts the ACA. However, other Republicans like Sen. Lindsey Graham have asserted their unwavering commitment to repealing and replacing President Obama’s hallmark legislative accomplishment.

Across the aisle, Democrats have moved beyond protecting Obamacare and are now voicing support for universal healthcare, which is echoed in the party’s official platform. The recent election of Alabama Senator Doug Jones may help Democrats in their efforts to defend and advance healthcare reform. With the 2018 midterm elections rapidly approaching, change may be this year’s only constant.

Confused about what all of this means for your patients and practice? Reach out!

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