Annual US Health Insurance Market Update
As we are nearing the ACA/Obamacare open enrollment period for 2020 individual health insurance and approaching the annual renewal for the vast majority of small business group health plans, I am providing information regarding changes that are happening in the market in 2020 to help you get prepared to find the BEST possible health plan for your situation and needs.
I also know that if you are on an ACA/Obamacare individual plan you may have already received your current plan’s renewal information for next year, so I hope this also provides some context to the planned rate increases or decreases, plan changes and cancellations, etc. that you are seeing.
Below you will find changes that are happening at both the federal level and links to more information in the states where US Insurance Solutions is currently licensed. Click the link for your home state to get more information about what is happening where you live.
Please review this information and then, if you haven’t already done so, go to my online calendar (and at the bottom of this page) and set an appointment for us to talk about your options for 2020.
Alternative Health Plan Solutions Updates
As a result of efforts by the current administration to provide more CHOICES for US individuals and small businesses than the one-size-fits-all ACA/Obamacare plans, there are MORE and BETTER affordable alternative plan options than there have been in years.
Some of the notable changes that have led to this expansion of alternative plan options include:
- Beginning in 2019, the elimination of the federal tax penalty for not having an ACA/Obamacare “qualified” health plan
- Extending the duration of Short Term Medical plans up to 12 months with the ability to renew for up to a total of 36 months
- Reviving the ability for businesses to offer a few different Health Reimbursement Arrangements (HRAs) as an alternative to a group health insurance plan. I won’t discuss these HRA programs here, but there was one that started in 2019 (QSEHRA) and two more becoming available in 2020 (ICHRA and Excepted Benefit HRA).
- On 7/30/2019 the administration proposed rules that will require hospitals to disclose their negotiated rates with health insurers and further reduce rates for some doctor services. The lack of price transparency and a TRUE “market” in healthcare is a BIG part of the problems with the US healthcare system.
NOTE: At US Insurance Solutions, we are NOT waiting for the industry or politicians to do the RIGHT thing. We have created a long list of “free market” healthcare tools and resources to help you get the best value when you need care no matter what type of health insurance you have. Please visit our US Healthcare Resources page and take some time to educate yourself on how to be a better healthcare “consumer.”
As noted on our US Insurance Solutions home page, if you are looking for an individual/family health plan and make too much money to get a tax credit subsidy from the government, one of our NAHP alternative health plan solutions may be just what you need! OR…
If you own (or work for) a small business with under 50 employees, and meet certain criteria, one of our NAHP alternative group health plans could be a better option than an ACA/Obamacare, fully insured group health plan.
Again, click on the link for your home state (below) to learn more about the alternative health plan changes and updates where you live.
On the other hand, for individuals who are eligible for a tax credit subsidy to help pay their premium and/or have significant health issues. Similarly, for small businesses who don't have enough people for an alternative plan and/or have people with significant health issues in their group, I can help find the best fully insured ACA/Obamacare small group plan. Please review the following…
Federal ACA/Obamacare Changes
The following are some of the main changes happening with ACA/Obamacare plans.
Insurance companies entering or expanding in ACA/Obamacare individual markets:
More than a dozen insurers plan to enter new Obamacare markets for 2020. Among them is the venture capital-backed startup Bright Health. Bright Health, which already offers ACA plans in markets in two markets, will roll out offerings in five more cities for next year. Oscar Insurance Corp., another startup, will enter six new markets. Other insurers including Centene Corp (Ambetter), Cigna. and Medica have also announced expansion plans.
As noted in the following paragraphs, some of the main reasons you are seeing this expansion is that premiums and deductibles are now HIGH enough and provider networks are now SMALL enough for insurance companies to make money on individual ACA/Obamacare plans.
Changes to out of pocket limits and deductibles:
For the SEVENTH year in a row, the maximum deductible and out of pocket limits for Obamacare compliant plans are on the rise! The government sets a limit on how much these maximums can be. Family maximums can be twice as high as the maximum amount in a plan covering just one person (a “self-only plan”).
For 2020, the self-only maximum deductible and out of pocket limit can be up to $8,150 and the family maximum, up to $16,300. For high-deductible plans that are compatible with Health Savings Accounts (HSAs) they are lower with limits up to $6,900 for individuals and $13,800 for families.
Lower rate increase percentages on individual plans around the country:
It is pretty clear that the insurance companies offering individual ACA/Obamacare plans have finally raised rates high enough, shrunk provider networks down far enough AND raised deductibles and out of pocket limits high enough (see above) that they don’t continue to need big rate increases to make money on individual ACA/Obamacare plans. Some are even able to reduce their rates by small amounts.
Personal Note: While I would much rather see rate decreases or NO to very low increases in ACA/Obamacare plans, I believe we have reached a point where any positive news is (as the old saying goes), "like putting lipstick on a pig." No matter what you do to spruce it up, it's still a PIG!
Small Group Plans – Not Joining the Party
Unfortunately, in the ACA/Obamacare small group market you are not going to see the same expansion and lower rate increases you are seeing in the individual market.
Fully insured, small group health plans must comply with ALL the same rules and coverage mandates as the individual plans. However, among other factors, group plans typically still offer larger PPO networks, which are more costly to insurance companies.
In the State Changes section below I have outlined as many of the proposed rate changes as I could find in your state for both individual and small group health insurers.
State by State Changes and Updates
As noted above, please click on the link for your state for more details on what is happening with both the Alternative Health Plans market and ACA/Obamacare plans where you live.
U.S. Insurance Solutions is here to help
Remember, you are NOT in this alone…I am here to help! As your Personal Health Insurance Advisor, my goal is to make your life easier by taking the hassle out of finding the right health plan for your situation and needs.
To discuss your health insurance options and make sure you have the best possible health plan for your situation, please go to the link above with the image that says CALL ME and schedule a call with me on a day and time that works for you, and I will call you to review your options.