If you are receiving free health insurance or reduced coverage through Medicaid, it is important that you understand the latest program regulations to take effect under the Trump Administration.
While some of these regulations do not affect you as a beneficiary, they may have effects on future coverage, and the eligibility criteria for potential new enrollees.
Medical insurance is an important investment for many Americans, since it can help keep them and their family members healthy, and avoiding financial debt due to medical bills.
The latest laws passed by the Trump Administration have changed some legislation from the Affordable Care (ACA), and may have effects on the health insurance marketplace and Medicaid recipients.
To learn more about the changes made to the healthcare bill, and how it may affect you and your coverage, review the following information.
State Rules on Free Health Insurance
If you receive affordable health insurance or free coverage through Medicaid, one of the most significant changes include the way states obtain their funding for the program and expansion rollback.
Through Trump’s Better Care Act (BCRA), the Medicaid expansion that occurred through the ACA will be rolled back. This rollback will occur over the next six years, and by 2020, no new enrollees will be able to join the program under these expansion guidelines.
Under the BCRA, funding for Medicaid insurance has also changed. Under the ACA, the program was funded through federal and state governments. The state government funding that was dedicated to the program was also always matched by the federal government.
However, with the passing of the BCRA, Medicaid is funded only by the state through per-capita or block grants. The state can set its own budget for the program, based on past expenses.
If you have recently completed a Medicaid application, or are thinking about enrolling in the program, these funding changes, and the expansion rollback, may affect you. Without the previously matched federal funds, states may not be able to provide as much funding to the program.
Therefore, medical insurance recipients through Medicaid may be denied treatments. New applicants may be denied enrollment.
Medicaid Insurance Work Requirements
Under Trumpcare and the new BCRA, states are also responsible for setting their own Medicaid requirements and guidelines. One of the most recent requirements imposed in several states was the work requirement.
Under the ACA, Medicaid recipients were not required to work to continue to receive coverage.
With this guideline imposed through the BCRA, a state government can choose to only provide free health insurance or discounted coverage through Medicaid, if the enrollee meets specific work requirements. For example, a state government can decide to only provide coverage to an applicant who works 40 hours per week.
While each state can set its own parameters for the work requirement, there must be logical exceptions. For example, the work requirement may not apply to:
- Pregnant women.
- Full-time students.
- Disabled recipients.
The effects that Trumpcare 2018 and the BCRA have on you as a Medicaid recipient may vary, depending on your location. Since each state is responsible for its own program funding and guidelines, you may experience changes in coverage and enrollment, or you may experience no effects.
BCRA and the Health Insurance Marketplace
Through the health insurance marketplace, you can still browse insurance plans and sign up for Medicaid or Children’s Health Insurance Program (CHIP), if you qualify. With the passing of the BCRA, you are no longer required to carry medical insurance, and the penalties for not having insurance are eliminated.
However, if you do not maintain continuous coverage, you will see a 30 percent increase in insurance premiums when you attempt to shop for coverage, once again.
With the passing of this legislation, insurance companies can offer additional affordable health insurance plans to the public, even if these plans do not meet ACA guidelines. However, each insurer must offer at least one plan that does meet the ACA requirements.
With Trumpcare in effect, insurers would still be required to offer health insurance coverage to individuals with pre-existing conditions. The insurance companies are provided funding that will help to offset the added funds of providing medical insurance to these riskier enrollees.
While the BCRA cannot provide free health insurance, the legislation will allow insured individuals to use the non-taxable money in their Health Savings Accounts (HSAs) to pay for their insurance premiums. With this legislation, more funding is provided to help drive down the high costs of out-of-pocket medical expenses and insurance deductibles.
Under the Trumpcare 2018 legislation, individuals who choose to enroll in catastrophic plans can obtain discounts in the form of tax credits. These plans have small networks, high deductibles and limit how much can be spent each year.
However, catastrophic plan enrollees can visit primary care physicians up to three times per year, and are responsible for lower, more affordable premiums.
What are Trumpcare plans?
Affordable health insurance is also offered through short-term health insurance plans, which have been deregulated by the BCRA. According to the legislation passed by the HHS (Health and Human Services), these short-term health care plans can now have one-year terms, which is much longer than their previous terms of only three months.
These short-term plans are also referred to as Trumpcare plans, because of the deregulations the Administration passed on this type of insurance. These plans often offer less coverage than plans that meet ACA guidelines, but they may be a good fit for low-income families that cannot enroll in Medicaid.
Most short-term policies have spending caps of $1 or $2 million. Additionally, insurers offering short-term plans can reject applicants, unlike ACA insurance companies that are required to provide coverage, even for applicants with pre-existing conditions.
One of the benefits of steering away from the health insurance marketplace, and obtaining a short-term plan, is the price. In most cases, these plans are about half the cost of plans that meet ACA regulations. Enrollees are not required to pay for the entire cost of the plan up front, even if they sign up for policies with three-month terms.
A Trumpcare 2018 plan is not the best choice for individuals who have current medical conditions, who are pregnant or who plan to receive medical treatments and services during the term. Short-term plans are usually best for individuals who are looking for basic coverage and a financial safeguard against a potential medical emergency.