Page 36 - Leisure Living Magazine May 2017

The Affordable Care Act a.k.a.
“Obamacare” - My Predictions On
What To Prepare For In 2018
By Steve Gulas, Bolte Insurance, www.bolteinsurance.com
At this time, with Congress having not passed a new healthcare reform bill, it is unlikely that there will be significant changes in the individual market that is mandated by reform laws for 2018 plans. Many of the changes that we will most likely see when 2018 Plan information comes out this Fall will be due to the high claims experience of insurance carriers operating in the market, as opposed to changes mandated by a reform bill. Most likely any reform changes passed by congress would not be implemented until plan year 2019, at the earliest, due to the time needed from the passing of a bill to it being implemented.
In 2017 we saw 3 trends and I predict more of the same in 2018. These three trends are :
1. Higher Premiums.
2. Fewer insurance companies participating in the Individual marketplace.
3. Fewer doctors and hospitals contracting with the remaining insurance carriers, due to lower provider reimbursement
rates.
Unfortunately none of this is good news for the individual health insurance consumer.
What is creating the problem with “Obamacare” in the Individual Market?
I would call it “Unintended Adverse Selection”. The individual marketplace attracted many people to purchase coverage that had high medical utilization, to a degree no one predicted when the bill was first passed. The real issue is where does all the money come from to pay the claims of the people insured in this market? Almost all of the insurance companies who decided to stop doing business in this market made their decision to exit the market for one reason. That reason is that they lost money in the market, and a lot of it. For most companies, the claims they paid significantly exceeded the premiums they
collected from the people they insured. Both Ottawa and Erie Counties went from 7 insurance companies offering plans in 2016 down to 2 in 2017. Anthem and Paramount became the only two companies available to purchase coverage from in these two counties for 2017.
What is the solution to fix this situation with the A.C.A. - “Obamacare”?
There are really only two solutions, neither of which is popular, however they are the reality of the situation. 1.) There needs to be more money going into the system, from premiums or tax credits, to pay the claims. Or 2.) Less money being paid for care in terms of reimbursement to providers. Of course neither of these solutions are popular to consumers or providers, however at the end of the day there needs to be enough money to pay the claims of all the people insured in this market. Tough choices will need to be made on how to best do this to keep this market from further Implosion.
Bolte Insurance represents all Marketplace plans and we specialize in helping YOU find a plan that best meets your needs and budget. If you need help contact Steve Gulas or Chuck DeVore at 419-732-3111.
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36 |LeisureLiving May 2017
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