Volume 8 Issue 3
The First 100 Days and The New Health Care Bill: What They Mean for Seniors, Veterans and the Disabled
Much has been made of the first 100 days of President Trump’s administration, and of the American Health Care Act (AHCA). This bill was just passed by the House as the first step to repeal and replace the Affordable Care Act (ACA).
This issue of The ElderCounselor™ will highlight the activity of the President’s first 100+ days and the potential effects on seniors, veterans and the disabled.
President Trump’s First 100 Days
· Nomination and confirmation of Judge Neil Gorsuch to the Supreme Court.
· Establishing a hiring freeze for some federal government workers, excluding the military.
· Establishing a mandate that agencies abolish two regulations for every new one introduced.
· Creating an office of accountability at the Veterans Administration and removing restrictions on the Veterans Choice Program.
President Trump also signed into law The Veterans Choice Program (VCP) Extension and Improvement Act, improving the 2014 program that allows eligible veterans to receive care from providers in the community instead of only from the VA. There are three significant changes to the program:
1. It removes the Aug. 7, 2017 expiration date. Now the VCP will continue until the original $10 billion dollars is spent. Based on current estimates, funds for the VCP will last through January 2018 but could shift to fall of 2017 if more veterans use the program.
2. Before this law change, some veterans were required to pay the cost-shares/co-pays associated with their private health insurance. Those will no longer be required.
3. Previously, the VA had a restriction different from other health care providers regarding the exchange of health information. The law removes these restrictions and ensures that community providers have access to appropriate health information for veterans and brings the VA in line with other health care providers and federal standards related to the exchange of health information.
The American Health Care Act (AHCA)
Who Would Be Affected by the AHCA?
It is important to note that when people are required to buy insurance, this helps keep rates reasonable for people who are sick or have pre-existing conditions. The insurance markets set up through the ACA depend on a group of younger, healthier people blending into a diverse pool with older, sicker people. This type of blending (healthy people with unhealthy people) is intended to bring down the overall costs of insurance.
What’s in the AHCA?
· The mandates are gone. The individual mandate that required every person to have insurance or face fines is eliminated. So is the employer mandate which forced employers with at least 50 employees to provide healthcare coverage. Under the ACA, some employers had reduced employee hours and/or not hired more workers due to the costs of insurance.
· Insurers may apply a 30% surcharge to customers who let their coverage lapse for more than 63 days in the past year.
· Taxes on net investment income, insurers, drug makers and medical device manufacturers are gone.
· ACA’s income-based subsidies are replaced with age-related tax credits. These range from $2,000 to $14,000 per year for individuals and households.
· Insurers can charge higher premiums for older persons or persons with disabilities.
· The tax-free annual contribution to Health Savings Accounts doubles.
· Grown children up to age 26 can stay on their parents’ plans.
· Insurance companies would no longer be required to cover “essential” health services. The ACA currently requires coverage of essential health services in 10 areas: Outpatient care, emergency room trips, in-hospital care, pregnancy, maternity and newborn care, mental health and substance abuse disorder services, prescription drugs, rehabilitative services and habilitative services (including treatment for kids with autism or cerebral palsy), lab tests, preventative services (including vaccines and cancer screenings), and pediatric services (including dental and vision care for children).
Elimination of Essential Health Benefits
While eliminating mandatory coverage for the essential health benefits will lower premiums (in theory), many may not be able afford a higher premium and could go without needed care because outpatient or in-patient care would not be covered, nor would rehabilitative services. A potential result of this piece of AHCA would be millions who would be under insured, or go without needed medical services or prescriptions. Interestingly, the CBO found that removing the necessity of covering essential benefits would save less money than keeping them.
Additional Medicaid reforms include eliminating a state’s right to allow over $750,000 in home equity caps for unmarried applicants and eliminating the three month retroactive coverage rule, forcing individuals to file an application and supporting documentation the same month they are seeking eligibility. For younger Medicaid applicants, states would be allowed to impose work requirements on able-bodied individuals.
If you have any questions about how you or someone you work with may be affected by the topics discussed here, please don’t hesitate to reach out.
Law Offices of J.R. Hastings • 1003 Third Street, San Rafael, California 94901 • 415-450-6692