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What you Need to Know About the Current Changes to the ACA

What you Need to Know About the Current Changes to the ACA
Posted on Tuesday, July 10, 2018 by Rae Shanahan

We work in an industry where the adage that the only constant is change rings true.   

What-you-need-to-know-about-ACAWith compliance updates, and administration shifts, it’s important as HR and benefits pros that we keep a diligent eye on the news. However, we understand that with AE prep starting to kick off, you may not have the time to continuously check Twitter for any health industry or insurance updates. And while Congress hasn’t yet repealed the Affordable Care Act (ACA), the Trump administration continues to make changes.

To help you cut through the noise, we complied a helpful quick list of important changes to the Affordable Care Act that you should keep on your radar.

Here’s what you need to know.

  • Request to end coverage for pre-existing conditions. Earlier this summer, the Trump administration requested that a district court strike down the ACA provisions guaranteeing coverage to people with pre-existing conditions. This argument is based on the removal of the individual mandate which requires everyone carry health coverage, in last year’s tax bill. According to the administration, without the individual mandate in place, the other parts of the ACA pertaining to coverage should also be removed. The Trump administration called on the court to implement this request by January 1, 2019.
  • Freezing risk adjustments. At the beginning of July, the administration announced a freeze on a repayment program that reimburses insurance companies for the costs of insuring sicker customers. Known as risk adjustment, the program collects money from insurers in ACA marketplaces who have healthier customers and uses it to reimburse insurers with more expensive patients.
  • Outreach funding decreased. Just this week came the announcement from the Centers for Medicare & Medicaid Services that funding for insurance outreach services, known as “navigators,” will be slashed to $10 million for 2019, down from $36 million in 2018. This money is used to fund navigators who help customers sign up for insurance, often for the first time. Along with this funding change, groups that apply for funds will be encouraged to help customers sign up for plans that don’t comply with ACA regulations.

What does this mean for HR professionals?

Uncertainty in the marketplace and potential premium increases are the most immediate concerns for HR. It’s vital that HR professionals keep a close watch on any changes from their insurance partner in response to any of the recent administration actions. Be ready to communicate with your employees, especially if premium changes will affect their benefits. Plus, with the recent federal expansion of association health plans – there may soon be other affordable solutions to the ACA.

But it’s also important for HR to assure employees that little may change in the short term. Legal challenges and marketplace effects can take time, and there’s no guarantee that major changes will happen right away. To ensure an open and transparent communication channel, think about providing a monthly or quarterly newsletter to your employees to keep them abreast of any industry changes coming down the pipeline. This type of communication can also help to increase empathy and trust in your workplace.

With vigilance and open communication, HR can navigate the continual uncertainty of the healthcare marketplace and provide information to their employees.

Want to stay on top of healthcare policy updates and compliance?