Insurance Questions Abound post-Election

As the dust settles after the 2016 presidential election, many questions remain unanswered related to the future of the Patient Protection and Affordable Care Act (PPACA), commonly referred to as Obamacare, and MedHQ’s seasoned human resources professionals continue to take the pulse of ambulatory surgery center (ASC) employee health insurance.

Throughout his campaign, President-elect Donald Trump promised to repeal and replace Obamacare. And in fact Republicans from both houses of Congress were able to come together and approve a repeal of key provisions of PPACA, thereby demonstrating that PPACA “repeal” may indeed be possible. So while Congress and the executive branches of government now appear aligned on a repeal and replace goal, it is yet unclear the precise form of legislation will ultimately pass congress and be signed into law by the president. As details unfold, we can try and read the tea leaves and predict what may happen. At this point it appears that the ultimate solution includes a strengthening or at least continuation of Health Savings Accounts (HSAs). Whatever happens, the fact remains that healthcare costs are on an upward climb, with the Department of Health and Human Services reporting in July 2016 that Americans could pay over $10,000 per person for the first time.

“Understandably, the lack of clarity has left ambulatory surgery center (ASC) employees wondering exactly what repeal and replace means,” said MedHQ CEO Tom Jacobs. “And as healthcare expenses continue to rise, employees rightfully want to know, ‘how will I be impacted?’”

Jacobs weighs in and provides insights and answers to some of the most commonly asked questions that ASC management may need to field from employees.

1. Will my costs and out-of-pocket expenses continue to increase? Premiums have skyrocketed due to PPACA mandated coverage requirements, particularly those for individuals and small groups. Jacobs said some of the coverage requirements could be undone under the new administration, which could slow the growth in premium rates. “Undoing some of the PPACA mandates could reduce pressure on rising premiums cost, and HSAs could be a great option,” he noted.
2. Will my insurance plan include my doctor? “This is an important consideration for everyone,” noted Jacobs, “but one of the ways the market is responding to rising costs is by narrowing providers and contracting with lower cost providers. The ability to choose a preferred provider may still be possible, but it may come at an increased cost.”
3. What will happen with Health Savings Accounts? President-elect Trump has stated he wants to make it easier to pass HSAs to heirs, and House Republicans want a two-fold increase in contribution limits. As of June 30, 2016, Americans had opened 18.2 million HSAs, which is a 25% increase from a year earlier, according toDevenir, an independent advisor and consultant in the health savings account industry. Additionally, assets had grown to an estimated $34.7 billion by June, up 22% over the previous year. “Participation in HSAs is growing and, as it stands to date, it appears that HSA plans will be encouraged, not discouraged,” Jacobs advised.
4. Will employers and health plans continue to innovate and add any new features, and will they work? “We field a lot of questions about the benefits of adding options to health plans such as telemedicine and access to retail (walk-in) clinics,” said Jacobs. He is hopeful that lessening of the regulatory environment will enable the market to provide more consumer-friendly services. “In the very first month we offered a telemedicine option, the number of claims avoided for people who accessed the telemedicine service offset entirely the cost of the telemedicine plan to the employer,” he said.
5. Will my employer establish a wellness program? According to the Society for Human Resources Management, in 2015, 80% of employers offered preventative wellness services and information. “This trend appears to have staying power,” noted Jacobs. “If employers elect to offer a wellness program, we recommend a tangible, results-driven program that supports the company culture. Enhancing productivity is key but ultimately, the goal is utilizing the program to decrease healthcare costs.”

To learn more about how MedHQ can improve your ASC’s operations and act as a liaison for all employee health insurance inquiries, email Tom Jacobs today or call: 708-492-0519.