Monthly Archives: April 2017

Will a Repeal of Obamacare Affect My Medicare?

Will a repeal of Obamacare affect my Medicare? 

I have been asked this by a number of concerned clients in response to the recent headlines from Washington.

First, to clear up any confusion, Medicare does not fall under Obamacare (ACA Law), or vice versa. These are two entirely separate government programs designed to serve two different groups of people with minimal overlap. To elaborate, Medicare provides insurance to Americans sixty-five and older or those with disabilities. It provides access to contracted providers nationwide and has its own cost mechanisms and eligibility rules. In contrast, Obamacare created marketplaces through which eligible consumers (those who are not Medicare eligible) can purchase insurance from insurance companies. Income based subsidies are possible for those who qualify and eligibility is determined by state residency and enrollment guidelines.

So, back to the question, would a repeal affect Medicare? I think more indirectly than directly. There are provisions in Obamacare that do affect Medicare, most notably Part D, the prescription drug program and specifically the Coverage Gap or “donut hole” within the drug plan design. A full repeal could negatively impact Medicare Part D beneficiaries and increase their share of cost. President Trump has not addressed this specific provision but only reiterated his personal wish to preserve Medicare and keep it functional.

Of the recent GOP reform plan that never came up to a vote, a change to the Coverage Gap provision was not one of them. The bigger question I think is, will major changes to one government healthcare program indirectly impact the economies of an entirely different government healthcare program. The answer is, maybe, or even probably, but how exactly cannot be determined at this time. Significant changes to Medicare are looming, but due to its own economic challenges. More on that in future issues.

UP A Creek?

Despite the fact that the first round of “Repeal and Replace” fizzled, a significant change is coming. In early April, the new administration announced that it would cut back the enrollment period for next year’s individual plans offered through the existing Affordable Care Act exchanges.

Previously the annual open enrollment period was from November 1 through January 31. The adjusted period will run from November 1 through December 15; a month and a half shorter. The administration has been quiet on important questions concerning the continuation of premium and cost sharing reduction subsidies and the insurance mandate and penalties, creating some uncertainty in the marketplace.

This indecision and the shortened enrollment period will make it difficult for carriers to prepare and price their plans for 2018. Some have threatened to withdraw from markets or the ACA entirely unless they receive some clear regulatory guidance. This could send the ACA up a creek without a paddle.  Stay tuned.