Obama Health Care in 2016

Obama Health Care appears to be here to stay (at least for one more year), and 2016 is shaping up to be a big year for change under the ACA. The cost of insurance premiums is going up with major insurers, new Obama health care plans are being introduced to the Marketplace, and penalties for remaining uninsured are more than doubling for some!  Here’s what you need to know about the changing state of health insurance in 2016.

Insurance companies, after working for a couple of years to implement Obama Health Care, are having to increase premiums in order to remain profitable.  In many states, 2016 insurance premiums will be increasing by double-digit percentages.  In North Carolina, consumers may be looking at a 35% rate increase for  BCBSNC® premiums alone.

But I thought Obama health care was supposed to LOWER costs?!?

The ACA does not guarantee that insurance rates will remain low. Its intention was to make health care more affordable for everyone, including those previously denied coverage due to preexisting conditions. However, in order for Obama health care under ACA to be successful, young and healthy individuals must buy into the insurance pool in order to offset the costs generated by older and sicker individuals. Unfortunately, not enough “young invincibles” are purchasing health insurance, and many insurers are finding themselves paying substantially higher claims.

Right now, the healthcare pool is stacked with a larger number of older and sicker participants, causing insurance companies to increase premiums to cover costs. Whether the healthcare pool eventually balances out with a mix of healthier individuals buying insurance plans remains to be seen.

2016 health insurance plans will also look a little different for some. In order to meet consumer expectations, provide value, and compete with other insurers, it is necessary for some insurance providers to be replace, or eliminate, previously offered plans from the Health Insurance Marketplace. So the plan you have in 2015 may, or may not, be available in 2016.

Even if your existing plan is still offered on the Marketplace, it is wise to revisit your coverage options. An agent at WNC Health Insurance will be happy to discuss any plan changes made by your insurer and assist you in finding new coverage options that meet your budget.

Finally, if you decide to venture forward without 2016 health insurance and are not exempt from the federal mandate to maintain coverage, you will face the harshest “individual responsibility payment” yet.

In 2016, those who fail to maintain health insurance will be fined $695 per adult and $347.50 per child (capped at $2,085 per household) – OR – a total of 2.5% of their combined gross annual household income (with no cap), whichever is higher. The fine for remaining uninsured will be assessed when filling your tax return for the year 2016 (in 2017).