The Patient Protection and Affordable Care Act (PPACA), also known as both the Affordable Care Act and Obamacare, made changes to annual and lifetime limitations on health insurance plans as well as the cost of preventive care and waiting periods for pre-existing conditions, among other stipulations.
The measures imposed by the act affected both individual health insurance plans available through the healthcare marketplace and those provided by employers who offer health insurance as an employment benefit. If there is an Obamacare repeal, employee health care requirements will likely change to scale with company size and profit margins. No one really knows Donald Trump’s healthcare plans, and how “TrumpCare” would affect employee health plans. That could mean major changes to employee health insurance plans.
Bans on Coverage Limits Lifted
Before the Affordable Care Act, most health insurance plans capped their coverage of medical expenses over a lifetime. The act also set new limits on the amount of money that insurance companies could set as deductibles, coinsurance, or copayments on a yearly basis.
While most businesses offered health insurance plans with strict limits on out-of-pocket expenses anyway, the repeal of Obamacare may open the door for employers to provide low-premium plans with extremely poor coverage and low annual and lifetime coverage limits.
Waiting Periods Reinstated
Before Obamacare, employers used to be able to determine the waiting period before employees were eligible for coverage. However, the enactment of the ACA limited the waiting period to no more than 90 days. In the wake of an Obamacare repeal, employers will again be able to make employees wait indefinitely for benefits.
Similarly, patients who entered into healthcare plans with pre-existing conditions often had to wait for periods of up to a year before their insurance plan would cover their conditions. Without the ACA, patients who suffer from chronic and preexisting conditions will again have to wait after enrolling in a new health care plan before they can receive coverage for their health issues.
Large Group Plan Coverage Standards Nixed
PPACA mandated that large companies comply with a minimum value standard that pays at least 60 percent of the cost of covered services. Though large group plans were not held to the same standard as individual and small group plans regarding coverage for essential health benefits, employers had to make sure that employees could afford at least some level of hospitalization and preventive care.
Large group plans became more expensive as a result, and minimum coverage health plans disappeared. If Obamacare is repealed, low-cost, company-provided plans with nearly non-existent benefits will become legal and available for employers looking to minimize expenses.
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| Donald Trump has publicly vowed to repeal Obamacare. |
Prepare Now for Healthcare Changes
One of the universal benefits of Obamacare has been the prevention of discrimination by insurance companies against people with existing or recurring medical conditions. Even under employer-sponsored healthcare plans, patients are likely to face long waiting periods and denial of coverage.
With no concrete information on an Obamacare replacement act, prepare by ensuring that you currently have a healthcare plan that covers your conditions comprehensively or that you will have access to healthcare that at least covers part of your medical costs. Talk to your employer about possible changes so you will be ready for even drastic reductions in your healthcare coverage.
