Posted on 03/08/2017 11:38:31 AM PST by nickcarraway
The plan to repeal and replace Obamacare unveiled by House Republican leaders on Monday orders insurance companies to charge people 30 percent more in premiums for a full year if they did not have insurance for 63 days or more in the previous year.
The sections of the Republican bill that create this mandate on insurance companies are titled: “Continuous Health Insurance Coverage Incentive,” and “Encouraging Continuous Health Insurance Coverage.”
The first subsection of the “Encouraging Continuous Health Insurance Coverage” section is entitled: “Penalty Applied.”
This subsection says insurance companies “shall” impose the penalty.
“[A] health insurance issuer offering health insurance coverage in the individual or small group market shall, in the case of an individual who is an applicable policyholder of such coverage…increase the monthly premium rate otherwise applicable to such individual for such coverage during each month of such period, by an amount determined under paragraph (2),” says the bill.
Paragraph 2 goes on to explain that the “increase” in premiums the government will require is 30 percent over the normal premium for the plan.
“The amount determined under this paragraph for an applicable policyholder…is the amount that is equal to 30 percent of the monthly premium rate otherwise applicable to such applicable policyholder for such coverage during such month,” the Republican bill says.
The proposed legislation goes on to say that the burden of proof will be with the individual American seeking to buy health insurance. If they cannot document that they did not have a 63-day lapse in insurance during the previous year, they must pay the 30-percent penalty.
The person who must pay the penalty, the bill says, is “an individual who…cannot demonstrate (through presentation of certifications described in section 2704(e) or in such manner as may be specified in regulations, such as a return, or a statement made under section 6055(d) or 36C of the Internal Revenue Code of 1986), during the look-back period that with respect to such enrollment period, there was not a period of at least 63 continuous days during which the individual did not have creditable coverage.”
The penalty also will be assessed against young people who age out of their parents’ plans and do not sign up for their own insurance in the next open enrollment period.
It will apply, the Republican bill says, “in the case of an individual who had been enrolled under dependent coverage…and such dependent coverage of such individual ceased because of the age of such individual, is not enrolling during the first open enrollment period following the date on which such coverage ceased.”
The summary of the proposal published by the House Energy and Commerce Committee also points to this 30-percent increase in insurance premiums that the government will order insurance companies to impose on people who failed to buy insurance for 63 days.
“Beginning in open enrollment for benefit year 2019, there will be a 12-month lookback period to determine if the applicant went longer than 63 days without continuous health insurance coverage,” says the summary.
“If the applicant had a lapse in coverage for greater than 63 days, issuers will assess a flat 30 percent late-enrollment surcharge on top of their base premium based on their decision to forgo coverage,” says the summary. “This late-enrollment surcharge would be the same for all market entrants, regardless of health status, and discontinued after 12 months, incentivizing enrollees to remain covered.”
At the same time, the House Ways and Means Committee’s summary of the amendments that Republican leaders are proposing to the Obamacare law points out that one of those amendment would reduce the Obamacare penalty for not signing up for insurance to “zero.”
“Under current law, most individuals are required to purchase health insurance or pay a penalty,” says the Ways and Means summary. “This section would reduce the penalty to zero for failure to maintain minimum essential coverage; effectively repealing the individual mandate.”
In sum, the Republican plan to repeal and replace Obamacare would eliminate from existing law the penalty for not signing up for insurance and add to existing law a one-year 30 percent premium hike for anyone who fails to buy insurance for 63 days or more.
Buying across state lines will not be rolled out until phase three because it cannot be passed under reconciliation.
the only plans I want to see for insurance is the barebones plans....no free birth control , no gender reassignment surgery’s , no free doctor visit for your yearly medical. it should be insurance so if you get sick you don’t lose your house paying for the illness or accident. if some one wants to risk everything they have by not getting insurance that’s the risk. we did not have an everyone is insured plan till recently and those that were not insured were taken care of but they lost there savings and retirement if they chose not to be insured before the state and federal government stepped in.
More Ryan bait and switch!
Vacate the Chair!
Agreed. However, I knew of a person who was in this situation with the insurance company. He had cancer and got into a fight with his insurance company. Not something that is fun while a person is fighting (his wife too) for their life.
In the end, he won the fight with the insurance company but not for his life.
And isn’t exactly the same issue only reversed as “a person only buy insurance when they need it” or an insurance company only insures a person if and while they don’t use it?
The penalty will not be during the cross over period. My understanding is it will be after this has been in effect. For instance, if the pass the law now and you don’t sign up for it but wait until you find out next fall you have diabetes and then sign up. You will pay a penalty on your premium but you will get coverage
Individual insurance companies may have had their own regulations about that for group plans, but I’m pretty sure there was never a restriction on buying an individual insurance policy at any time (it might have varied by state).
I agree with you. It’s also important to raise the cap on your personal injury benefit in your auto insurance policy as much as possible. For young people, auto accidents are the single biggest reason for a person to need medical treatment.
We need to do everything we can to help bring the costs of health care down. I would also like to add about seeing some torte reform with capping some of these injury claims. Also, put the burden of the costs of bringing lawsuits on those bringing the suits so that only the just ones are considered.
Our local leftist TV stations have these injury lawyers commercials going 24/7. This is a big source of of funding for these leftist propaganda outlets. Reining in this madness would help solve 2 problems we have now in America.
CGato
An insurance company that covers your medical expenses has a vested interest in seeing you die -- quickly.
And they will again. But before, insurance companies could turn you down for pre existing conditions. BUT you would be covered if you signed up under a group policy. There again, it depended on the policy your employer offered.
What they are talking about now is high risk pools
What you’ve described there is a typical cost-sharing program for medical bills offered by religious organizations.
If you take a random group of ten people, you'll likely find that nine of them have almost $0 per year in medical expenses, and the tenth has $20,000/year in expenses (these numbers aren't correct; I'm using them just to make a point). It is lunacy to have all ten of these people pay $2,000/year in insurance premiums just to cover the health care costs of one person.
Phase three???
Screw that, this reminds me of how congress promised Ronald Reagan immigration reform if he approved their amnesty and that NEVER happened.
Phase three just tells me the establishment is buying time to delay this as long as possible, maybe even after President Trump is gone, so that we will be stuck with this POS.
It's that old saying, "fool me once...." is where I'm coming from.
CGato
I got a quote for an individual policy yesterday. There is a 12 month waiting period on pre-existing conditions now.
Agreed. :(
Because they are also requiring insurers to cover pre-existing conditions. If you're going to do that then you've got to do something to prevent people from signing up for insurance only once they learn they're sick.
I got a quote for an individual policy yesterday. There is a 12 month waiting period on pre-existing conditions now if you are not currently insured.
You still qualify for Obamacare if you have a Catastrophic condition. Open enrollment ended 1/31/17
But they can’t do that either. “Repeal” was promised.
Doesn’t that defeat the purpose of the entire scheme? What if you’ve had a qualifying event like losing your job and employer provided coverage?
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