“ObamaCare” in 2018 ( Affordable Care Act )

“ObamaCare” in 2018 ( Affordable Care Act )

The Affordable Care Act Lives!

Well the Affordable Care Act is still the law of the land.  I am sure you are asking the question, “What does that mean to me”?  Good question.

  1. You can still buy health insurance.  Open enrollment for 2018 is from November 1st to December 15th, 2018.
  2. The costs sharing and premium subsidies are still being paid.  If you qualify for costs sharing and premium reductions you will still get help paying for your health insurance from the government.
  3. Cost Sharing is still available even after President Trump signed the executive order. In addition to providing help paying for premiums, the Affordable Care Act requires Marketplace insurers to offer cost sharing reduction plans to middle income consumers. These are silver plans with lower maximum out-of-pocket limits, deductibles, co-pays, and co-insurance, making access to health care services more affordable. The Oregon the DCBS (Department of Consumer & Business Services) has ordered health insurance companies offering silver plans to increase the cost of these plans by 7.1% to cover the payments they will not be receiving from the federal government. Most consumers who buy these plans also get premium subsidies which will also rise cover the additional costs.
  4. The mandate is still in place.  That means the penalty for not carrying health insurance is still in place.  President Trump or the congress has not changed the law.
  5. The IRS will continue to enforce the mandate.  It’s still the law.
  6. After December 15th you cannot sign up for health insurance coverage unless you qualify for a Special Enrollment Period.
  7. Do not delay in making an appointment with one of our health insurance agents.  Go to Our Booking Site and make an appointment today.


Health Insurance Coverage is a County By County Thing!

The health insurance options are not the same across the state of Oregon.  In fact, depending what county you live in will determine how many health insurers are providing health coverage to you.  In Portland up to five health insurers provide coverage.  Whereas in Douglas and Lincoln counties have only one insurer.  See the chart below to see which carriers are in your county.

What’s New For 2018 Besides Premium Increases?

“Although health insurance premiums will be increasing in 2018, for many Oregonians those increases will be offset by corresponding increases in subsidies or financial help available through Oregon’s Health Insurance Marketplace,” said DCBS Director Patrick Allen.  “Still, we know a large number of Oregonians who do not receive help will see increased costs.  We are committed to continuing to work on reforms that make insurance affordable to more people.”

All Oregonians who purchase their own insurance, even those who do not receive financial help in 2017, are encouraged to apply for assistance through the Marketplace in 2018.  They might be surprised by what they qualify for.  In 2017, Oregonians who received help with the costs of their health insurance paid on average $147 a month.

Rate increases have been moderate in Oregon because of the new Oregon Reinsurance Program.  The program reduced individual market rates by 6 percent, and added a 1.5 percent increase to the small group market.  Meanwhile medical costs continue to rise, driven by increased use and the cost of new specialized prescription drugs.  At the same time, costs of providing care continues to surpass premiums collected for many health insurance carriers.

If Your Health Insurance Carrier Is Dumping You-

You will be notified by letter that the carrier is no longer providing individual health insurance to you.  If you want to control your health insurance costs you need to be pro-active and pick up the phone or make an appointment with one of our health care specialist who will guide you through the maze to buy a new health plan that fits your needs.  If you choose to do nothing, you will be mapped into another carrier’s health insurance plan.  The problem with just sitting back and letting it happen is you lose control over what doctor you get to see and what price you are expecting to pay them for a visit.  When you use out of network health care providers you may not have coverage under that health plan for that provider’s charges or fees.  Therefore, you want to use an in network provider whenever possible.  You can look and see if your health care providers are on the insurers health insurance network by going to the individual carriers’ website and looking up the networks under the plan you are interested in buying.

I urge you to take the time and really look at the plans that are offered to you, please feel free to pick up the phone and call one of our health insurance professionals and ask a lot of questions 800-452-6826 or book an appointment with us here.  We will have after hours and weekend appointments available, please call to schedule these.

Thank you,
Rex Lesueur




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