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How the new Trump Care bill could affect health care consumers

Sudhir Mathuria  Licensed  Professional Health Life 360 6776 Southwest Freeway, Suite # 178 Houston TX 77074 713-771-2900 www.MyMedicarePlanning.com

Sudhir Mathuria
Licensed Professional
Health Life 360
6776 Southwest Freeway, Suite # 178
Houston TX 77074
713-771-2900
www.MyMedicarePlanning.com

Here are some key takeaways about the newest version of the American Health Care Act (AHCA), also referred to as Trump care.
Pre-existing conditions
Technically, people with pre-existing conditions may not be barred from obtaining insurance coverage under the AHCA. However, their coverage options could be seriously affected by this bill. States would be permitted to apply for waivers to exempt insurance companies from a community rating provision and allow them to charge far higher premiums for people with pre-existing conditions.
The community rating provision is a way of setting premiums and is designed to ensure risk is spread evenly across a larger pool.
Under the AHCA, people in certain states could face far higher premiums for pre-existing conditions. States that apply for this waiver would have to implement high-risk insurance pools to accommodate them. But health care experts are skeptical that these high-risk pools would have enough money to fully cover people in need.
High-risk pools
The newest version of the bill allocates $8 billion over five years for states that apply for the waiver, to help cover the costs of care for people with pre-existing conditions. Most likely, the states would use this money to help fund a high-risk insurance pool for residents with pre-existing conditions.
Pollitz said it’s unclear why $8 billion was picked as an appropriate number to fund a high-risk insurance pool, especially since it’s unknown how many states would apply for the waiver and how many people with pre-existing conditions would need help paying for care.
“Eight billion is not a number that bears any resemblance … to what this would cost,” she told ABC News.
Before the Affordable Care Act, 35 states had high-risk pools to cover residents who otherwise would not be insured because of pre-existing conditions. The Kaiser Family Foundation found that state high-risk pools often had significantly higher premiums and likely included just a small fraction of people who needed coverage.
Health care mandate
The Trump care bill does away with the mandate under the ACA that requires people have health insurance or pay a fine. Under the new bill, people who go 60 days without health coverage would be penalized if they rejoin a health plan; they would face a 30 percent penalty on their insurance policy for one year.
Christine Eibner, a senior economist and professor at the Pardee Rand Graduate School, told ABC News in an earlier interview that some people would likely not view insurance as a necessity and be more willing to bet that they could afford the 30 percent surcharge on health insurance down the line.
“It doesn’t seem that punitive,” she said. “You’re still guaranteed that you can get health insurance … For some people, that might be affordable, and you might end up with employer coverage in the interim.”
Essential health benefits
Under the ACA, certain essential health benefits — including maternal care, prescription coverage and mental health care — must be a part of any insurance plan. Under the new Trump care bill, states could apply for a waiver to exempt insurance plans from including these benefits in their plans. To qualify, the states would need to prove they could either lower the cost of health care for people or increase the number of people covered by insurance.
Health experts say that if this provision is enacted, costs for people in need of specific essential health benefits will likely face higher premiums. “If somebody needs maternity care, it will be much more expensive,” Eibner said.
To choose right Healthcare OR Medicare plan contact Sudhir Mathuria @ 713-771-2900.


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