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You will find many affordable Trumpcare Health Insurance plans for individuals, families and the self-employed in the market place. Many are available online and it is not hard to find Trumpcare Health Insurance that meet your needs and budget as long as you know where to look and how to effectively shop for good coverage. All the Trumpcare Health Insurance companies in Texas offer low cost, affordable Trumpcare Health Insurance plans to cover the most basic needs as well as catastrophic coverage. You can find affordable Texas Trumpcare Health Insurance plans from Aetna, Blue Cross Blue Shield, Cigna, Humana, United Healthcare and more. Here are just a few to consider.
List of Obamacare Taxes Repealed
The American Health Care Act (HR 1628) passed by the House today reduces taxes on the American people by over $1 trillion. The bill abolishes the following taxes imposed by Obama and the Democrat party in 2010 as part of Obamacare:
-Abolishes the Obamacare Individual Mandate Tax which hits 8 million Americans each year.
-Abolishes the Obamacare Employer Mandate Tax. Together with repeal of the Individual Mandate Tax repeal this is a $270 billion tax cut.
-Abolishes Obamacare’s Medicine Cabinet Tax which hits 20 million Americans with Health Savings Accounts and 30 million Americans with Flexible Spending Accounts. This is a $6 billion tax cut.
-Abolishes Obamacare’s Flexible Spending Account tax on 30 million Americans. This is a $20 billion tax cut.
-Abolishes Obamacare’s Chronic Care Tax on 10 million Americans with high out of pocket medical expenses. This is a $126 billion tax cut.
-Abolishes Obamacare’s HSA withdrawal tax. This is a $100 million tax cut.
-Abolishes Obamacare’s 10% excise tax on small businesses with indoor tanning services. This is a $600 million tax cut.
-Abolishes the Obamacare health insurance tax. This is a $145 billion tax cut.
-Abolishes the Obamacare 3.8% surtax on investment income. This is a $172 billion tax cut.
-Abolishes the Obamacare medical device tax. This is a $20 billion tax cut.
-Abolishes the Obamacare tax on prescription medicine. This is a $28 billion tax cut.
-Abolishes the Obamacare tax on retiree prescription drug coverage. This is a $2 billion tax cut.
As a presidential candidate in 2008, Barack Obama had promised repeatedly that he would not raise any tax on any American earning less than $250,000 per year. He broke the promise when he signed Obamacare. With the passage of the House GOP bill, tens of millions of middle income Americans will get tax relief from Obamacare’s long list of tax hikes.
Trump Signs Executive Order to Ease Burden of Trumpcare
However, these Executive orders are normal when an opposing party takes office. ALL Presidents have done this when taking office. They freeze executive orders that are in process and are not yet implemented, so they can reroute them in the direction of the new administration’s goals. That’s the Executive Order freeze that Trump signed. Then, they also instruct Department heads on how to handle current rules/regs that are within their power to interpret and manipulate. You notice it most when an opposing party takes office, and you notice it even more when the new party’s goals are at enormous odds with the prior party. So, for instance, an anti-war President taking over from a pro-war President will make news by issuing an executive order that freezes rule-making and that eases the current rules/regs on those issues.
Then the rest of it comes later. What comes later are repeals, delays and waivers of rules/regs that are already enacted. Delays and waivers are first. Repeals of enacted rules/regs take longer. So, for instance, Trump just allowed the Department head of the Treasury Dept (of which the IRS is a branch) to ease the burden/cost of certain rules/regs that are already implemented. If the IRS/Treasury wishes, they can declare that they will not enforce the individual mandate penalty. They may do so quickly. They may take their time in doing so, because it will cause immediate adverse selection, and possible carrier withdrawal from the market. That might be what they want. CMS could issue a waiver saying carriers can withdraw without penalty. So, if that is what they want, IRS and CMS will do it together. If preserving the fragile market until a replacement system is in order is what they want, then they will take their time waiving the penalty until they can prop up a falling market. Or they might give more hardship exemptions, which partially waives the penalty for now. It really depends on their goals. Right now we know their big goal, but some of this is about the sub-goals inside the big goals.
What comes soon will be bigger news as we see how they coalesce around goals.
So, the administration is allowed to “WAIVE” or “DELAY ENFORCEMENT” of a rule. They can alter the way they interpret rules/regs. There are many laws, rules & regs about which the government simply turns their head and doesn’t look. An example is CMS and the SEP rules. It was law, it was in the rules/regs, but hc.gov would give out an SEP for anything, and didn’t care. Then, later when insurance companies cried loudly, CMS decided to pay attention to the rule/reg and they didn’t “look the other way” as much.
REPEALING a rule/reg takes a little longer. They cannot change a rule/reg that is already published with the Federal Register and is past its enactment date. What they do with those rules is go through the process of re-evaluation. So, for instance, take the short-term policy’s 3 month limit rule. It has been published, but not enacted until April. Take the Fixed Indemnity rule. It has been published AND enacted. So, the short-term rule could be halted before enactment. The Fixed Indemnity rule must be repealed. The process to repeal a rule/reg is to 1) Issue a proposed rule; 2) open it for comments for a stated time; 3) Issue a Final Rule; 4) Publish it; 5) File it with the Federal Register; 6) Enact it on the date that it says is the enactment date.
That doesn’t mean that an enacted rule cannot be manipulated by WAIVER, DELAYING ENFORCEMENT, reinterpreting it and ignoring it. Take “delaying enforcement” for instance. To delay enforcement, there must be a penalty to delay enforcement about. So, for instance the Fixed Indemnity and Short-Term rules have no penalty. But the individual mandate has a penalty. The individual mandate is not actually a rule/reg. It is a part of the ACA law itself. But the ACA law gave enforcement rights to the IRS. The IRS can voluntarily delay enforcement of a penalty. They’ve done it before, many times. For instance, there are non-discrimination rules written in the ACA law that apply to groups, yet the enforcement has been delayed from the outset of the law and has never been enforced. In fact, they issued a statement saying that enforcement was delayed INDEFINITELY. But to delay enforcement, you have to look at rules/regs that have a penalty to delay enforcement about. The individual mandate is a prime example. So, is the group reporting requirements and penalties. The group reporting requirements and penalties might actually be axed faster, just because they do not cause a market to crash and the reporting requirements are imminent – they are this spring.
It’s important to know what is a rule/reg and what is a law. The administration right now is only able to make changes that are in the rules/regs under which the Secretaries of these Departments have been given authority or in enforcement of penalties or burdens of cost for portions of the law over which they have authority. There are lots of things that they can do with these rules/regs, penalties, costs and enforcement. There are things they cannot do.
They cannot change the law without a bill that passes both houses of Congress and is signed by the President. So, for instance, Guaranteed Issue won’t change immediately because it is in the law and not subject to rules/regs or delayed enforcement. I do take note that the Executive Order gave more power to states to control their own markets. The states might find loopholes and might find ways to work around Guar Issue. However, they may not want to use those loopholes right now because it will cause a market to crash. Arizona actually has more of a chance of using those loopholes because we already have a crashed market that has 2% possibility of surviving to 2018. There are loopholes right now. ERISA plans (Level Funded, Self Funded etc.) are examples. Short-term plans are examples. But real, true removal of guaranteed issue laws takes more than just an executive order, because it is written in the law itself and not just subject to rules/regs, delays of enforcement, waivers or reinterpretation. The power given to the states was probably more about Medicaid than anything else, but we shall see.
Another thing they can do is defund. The House controls the purse strings, but departments are given funds to dole out to projects as they see fit. They can move the money around from one project to another, effectively disabling a project in its tracks. Healthcare.gov funding might be axed. It will be interesting to see what defunding choices they make.
Another thing they can do is to use the judicial branch. A quick example is the CSR funding. Currently President Obama’s administration was appealing the judge’s decision, but President Trump’s administration can drop their appeal. That would make the CSR funding issue crash to the floor. This would be an indication that they don’t care about the burden on insurers, insurer withdrawal, etc. Or, that they don’t care about a crashing market. They may not care for several valid reasons, one of which is because they have a replacement plan ready, or other funding mechanisms to replace the CSR funding mechanisms during the transition. They might even agree with the judge for a delayed enactment date of the damage to CSR funding. What they do next is very telling about where they intend to end up.
This is a dance that could move across the dance floor in multiple ways. It will be interesting to see what end-goals they are coalescing around. Expect the Department heads’ actions to give us a clue about what kind of repeal/replace is coming. If the IRS delays enforcement of the individual mandate, we know several things. Possibly they don’t care about adverse selection. Possibly they don’t care if the market crashes. Possibly they have a replacement system ready to go before the market crashes. But this Executive Order was just paving the way to move into a certain direction. The big news is coming next, because what they do next will be key indicators of the particulars in their plan.
As Republicans gear up for the next fight to push their proposed healthcare bill, the American Health Care Act (AHCA), through Congress and onto President Trump’s desk, an incredible number of Americans await the fate of coverage for pre-existing conditions. This particular feature regarding the healthcare bill – a staple protection under Obamacare – happens to be debated among healthcare analysts for months. Will Trumpcare cover pre-existing conditions? When you have a pre-existing condition, how will your health plan change under the proposed bill? These and other questions continue to plague politicians in Congress on each side of this aisle.
In a nutshell, the AHCA will not eliminate coverage for pre-existing conditions. Like the Affordable Care Act, Trumpcare will demand all health insurers to cover those who apply regardless of their medical background. But there are lots of key differences in what that coverage looks like under Trumpcare vs. the present law.
Precisely What Does “Pre-Existing” Mean?
Like its name suggests, a pre-existing condition is a medical problem that exists before you subscribe to medical health insurance. Before Obamacare became law, people with medical problems – ranging from asthma to cancer – might be denied medical insurance according to those medical problems. Insurance vendors defined pre-existing medical ailments in different ways, some with stricter guidelines than others. It’s likely you have been denied coverage for a number of different conditions, including:Diabetes,Chronic back problems,High blood pressure,Autoimmune disorders.
These are all fairly expensive conditions to treat over the course of someone’s life. But pre-existing conditions also extended to other health situations, such as pregnancy, that weren’t permanent. Imagine finding out that you were pregnant only to be denied health insurance for you and your growing child.
There’s no standard definition of a pre-existing condition other than that it must have been present before you signed up for health insurance. It doesn’t have to be diagnosed or treated, either.
For example, let’s say that you just got approved for health insurance. About a week later, you see your doctor for ongoing wrist pain, which is noted in your file as a problem you’ve discussed before. Your doctor diagnoses you with carpal tunnel syndrome and recommends surgery to correct the problem. Before the ACA took effect, your insurance company could deny the claim because you had a history of wrist pain before buying a policy. They could also deny your application for a new policy once you tried to sign up again.
There was a legitimate reason for doing things this way. Insurance is sold on the premise of a “what if” scenario – what if you break your leg or get the flu, for instance. The same principle applies to any kind of insurance. You don’t purchase flood insurance the day after your home gets destroyed by a flood. It’s too late. In order to prevent people from buying health insurance after accumulating lots of medical bills, insurers were able to deny people coverage if they already had health problems.
The problem here is that people with unavoidable medical problems, like type I diabetes or Crohn’s disease, were treated the same way. Likewise, pregnant women may have also faced the same discrimination. It essentially forced people who truly needed care, the sickest in the population, to forgo health insurance because it was too expensive.
Obamacare’s “Fix”
The Affordable Care Act sought to correct this problem, but it created a new problem in doing so. Under the ACA, people with pre-existing conditions can’t be denied coverage or charged more for coverage than healthy people. Insurers have to treat every applicant the same in terms of medical history, with the exception of smoking, a habit that insurers can still charge higher premiums for. This solution allowed millions of people to sign up for affordable health insurance for the first time, but there was a catch.
Suppose that after a flood destroyed your home, you were legally allowed to buy flood insurance the next day. You call your home insurance company, sign up for coverage, and then immediately file your first claim for damages. The same thing started happening once people with pre-existing conditions were able to purchase health insurance without medical underwriting. Insurance companies started losing money because they had to cover a sicker beneficiary base than they had anticipated.
The government assumed that more healthy people would sign up to balance out the influx of sicker participants, but that didn’t happen, primarily because the incentive was gone to buy health insurance in the first place. After all, if you can buy coverage after you have a problem, why should you waste money each month on insurance that you won’t use? The individual mandate, which forced everyone to buy coverage under threat of a tax penalty, wasn’t strong enough to motivate young and healthy individuals to buy health plans. The system started collapsing, evidenced by astronomical premium increases for 2017 in much of the country.
Please note: we are not advocating for a system under which people with medical problems are denied coverage. We are simply outlining one of the reasons insurance companies started charging much more money for coverage than initially expected. Pre-existing conditions are expensive to maintain, which is why companies charged more for these conditions before the ACA.
How Republicans Will Address Pre-existing Conditions
To reiterate, Republicans are not planning to eliminate protections for people with pre-existing conditions. Despite the fact that almost every Republican supports repealing the ACA, most people (conservatives and liberals alike) agree that the pre-existing conditions clause is a feature worth keeping. Instead, the difference lies in how Republicans intend to offer coverage to people with medical problems. Per the AHCA and recent amendments, several things could happen, including the following:
States could apply for a waiver from the requirement to offer health insurance without medical underwriting if they establish high-risk pools that demonstrably save them money.
If a person with a pre-existing condition allows his health insurance policy to lapse, then he could be charged more by the insurance company when he signs up for another plan later.
These provisions are specifically addressed in a recent set of changes to Trumpcare proposed by Rep. Tom MacArthur (R-NJ), known collectively as the MacArthur amendment. The amendment was an attempt to garner favor among far-right conservatives, specifically the House Freedom Caucus, and it worked. However, moderate Republicans object to these changes because they fear that the language strips away rights from people with pre-existing conditions.
A divided Republican Party now faces the possibility of healthcare reform grinding to a halt in light of the issue over pre-existing conditions. President Trump, for his part, seems unsure about what’s in his own bill, which only adds to the confusion. Optimistic members of Congress have suggested that they could push the AHCA to a House vote by next week, but there doesn’t appear to be widespread support even for the revised version. For people with medical problems, the debate over healthcare reform continues to play fast and loose with their care.
Guaranteed Issuance and Renewability for Mom and Pop Groups (expanded December 1, 2016)
Federal law does not consider a family-run business consisting of a husband and wife to be a small group health plan unless the business employs at least one common law employee who is neither spouse. Based on federal guidance, may a small group carrier refuse to issue new coverage or non-renew existing coverage for a small group that does not meet this federal definition?
No. Under Texas law, a small group carrier must issue coverage, consistent with TIC §1501.151, to a small employer with two or more employees, even if the employees are married to one another. A small group carrier may not non-renew coverage for an existing small group because the state and federal definitions of small group differ. In addition, TIC §1501.108 gives a covered employer the right to renew its group health coverage unless the employer fails to comply with the terms of the plan.
Federal law (42 US Code 300gg-91(e)(1)(B)) allows a state to elect to regulate coverage offered to very small groups as coverage in the small group market, and Texas considers a group of two eligible employees to be a small group, regardless of marital status. The Texas Insurance Code does not exclude spouses from the definition of “eligible employee” or exclude such employees in defining “small employer,” and consistent with this 28 TAC §26.7(d), prohibits a small group carrier from denying two individuals who are married the status of eligible employee solely on the basis that the two individuals are married. Commissioner’s Bulletin # B-0035-01 provides additional guidance regarding this requirement.
The Trump administration — which has been bashing Obamacare for months — on Wednesday said it would make a change that could lead to higher enrollment in Obamacare plans next year.
The administration said it would remove a technical speed bump in how internet-based insurance brokers sign up customers in health plans sold on HealthCare.gov, the federal Obamacare marketplace.
That change, which the brokers have sought for more than four years, is likely to make it easier for those third-party brokers to enroll customers in Obamacare plans by removing a requirement that they have customers ping-pong between the brokers’ websites and HealthCare.gov.
“Consumers applying for individual market coverage during the upcoming open enrollment period through direct enrollment partners will now be able to complete their application using one website,” said the Centers for Medicare and Medicaid Services.
And because the process will be easier, more people could end up enrolling, particularly customers who receive financial aid that reduces their monthly plan premiums.
Web brokers long have said that they can help increase Obamacare enrollment because of their marketing budgets, customer service and online shopping technology.
CMS, which runs HealthCare.gov, said the change was being made to reduce confusion and difficulty that customers had experienced when enrolling in HealthCare.gov plans by using web brokers.
“This is another important step to help create stability in the health insurance market,” said CMS Administrator Seema Verma.
“It is common sense to make it as simple and easy as possible for consumers to shop for and access health coverage. It is time to get the federal government out of the way and give patients the best tools to make their own health-care decision,” Verma said.
Scott Flanders, CEO of eHealth, the web-based broker that had been most vocal about the need for the kind of change announced Wednesday, said, “These new regulations are a step in the right direction.”
Flanders said the previous system of requiring customers to bounce back and forth between websites to enroll in subsidized Obamacare plans was “a ridiculous process.”
Shankar Srinivasan, co-founder and general manager of GetInsured, another major web health broker, also lauded the elimination of “the dreaded ‘double-redirect'” that had been required for his and other companies, and said it will “make it easier for people to shop for health insurance.”
HealthCare.gov sells individual health plans to people in 39 states. The federal exchange is responsible for more than 9 million Obamacare sign-ups, about 75 percent of the national enrollment tally.
For the past four years, HealthCare.gov has allowed web-based brokers to handle “direct enrollment” for customers. The 12 exchanges run by individual states and the District of Columbia do not allow web brokers to enroll customers in subsidized plans sold on those exchanges.
In direct enrollment, customers visit the broker’s website and sign up in plans that are offered on HealthCare.gov.
But federal officials had required the brokers to perform a so-called redirect when signing up those customers. That meant the broker had to electronically transfer the customer to HealthCare.gov, where the customer had their eligibility for financial aid verified.
The customer then was provided a link which they could click to be sent back to the broker’s website, and complete the enrollment process.
But many customers did not end up clicking that link, which in turn meant that brokers did not get their business, and the commission from a sign-up.
EHealth said that the completion rate for customers who started an enrollment process on their site without having to be sent to HealthCare.gov for subsidy eligibility was 40 percent. But that completion rate fell to just 10 percent when customers had to be sent to HealthCare.gov.
An eHealth spokesman said the company hoped that state-run Obamacare exchanges would follow HealthCare.gov’s example and allow direct enrollment for their health plans from web brokers.
Jeff Smedsrud, co-founder of Healthcare.com, a privately run health insurance comparison and shopping site, called the change in direct enrollment by brokers “a very nice win for consumers.”
“It makes buying health insurance online easier and faster — important things for young, healthy consumers,” Smedsrud said.
“Because enrollment will be quicker, those who want — but don’t need — health insurance will be more likely to buy. This is small, but an important step on a road to make health insurance a bit more affordable. It will improve the risk pool for those buying subsidy-eligible health plans.”
Wednesday’s announcement by CMS comes two days after the agency, citing very low enrollment, said that it will propose that HealthCare.gov stop enrolling people in SHOP plans sold on that exchange, and instead have insurers or brokers directly handle enrollment. SHOP plans are available for businesses that employ 50 or fewer full-time workers.
CMS said that under the proposal, HealthCare.gov would still handle eligibility verification for SHOP customers.
Obamacare will go into a death spiral on May 22 if the Trump administration chooses not to continue fighting in court to preserve cost-premium subsidies that were ruled illegal last year.
Fewer than 39,000 individuals are covered by a SHOP plan sold on HealthCare.gov, and fewer than 233,000 people are covered nationally by all SHOP plans sold on that exchange and by state-run Obamacare marketplaces
On May 12, 2016, U.S. District Court Judge Rosemary M. Collyer ruled House v. Burwell that the Obama Administration’s payment of cost-sharing subsidies without congressional approval was a violation of the Constitution’s Appropriations Clause.
The Obama odministration appealed the case to the United States Court of Appeals for the District of Columbia District, where it was renamed House v. Price to reflect the current Secretary of Health and Human Services. Monday, May 22 is the last day for the Trump administration to give notice to the Appellate Court if it wants to continue the appeal.
If Trump drops the appeal and ends the illegal cost-sharing subsidies, Obamacare Silver Plan healthcare premiums will jump by 19 percent. But the national average for Obamacare Silver Plan patient deductibles would also more than quadruple from $709,to $3,064, according to the amicus brief filed by America’s largest hospital groups.
The Democrat-controlled Congress was happy to pass Obamacare’s radical expansion of social justice entitlements, but had little interest in appropriating a $7 billion subsidy for healthcare insurance companies that saw their stock price triple under Obamacare.
President Obama then directed the IRS to make “Section 142 Offset Program” payments to Obamacare-participating insurers from the collection of penalties, fees and legal judgments against taxpayers. Congressman Ron Paul (R-TX) warned in 2010 that the IRS would hire up to 16,500 new agents to increase audits to generate more penalties and fees to subsidize Obamacare.
The Centers for Medicaid and Medicare are expected to release their “Proposed Health Insurance Rate Increases for the 2018 Coverage Year” on June 1. Obamacare premiums have increased by double digits each year since 2015, and 73 insurers announced last year that they were withdrawing from the program. As a result, many rural areas of the U.S. now only have one provider that can charge any rate it chooses.
According to the authoritative ACASignups.net blog, that closely follows state healthcare premium increase requests by insurers in each state, Virginia is looking at a 42.6 percent increase; Maryland a 22.6 percent increase; Oregon a 17 percent increase; and Connecticut a 13.9 percent increase.
Covered California, the Golden State’s Obamacare exchange, has been mum on what type of premium increase its participating insurers will ask for. But the San Francisco Business Journal reported that the California Institute for Regenerative Medicine estimated that Covered California healthcare premiums for 2018 would rise between 28 and 49 percent, not including the 19 percent added cost if the Trump administration drops the illegal cost-sharing appeal.
The hospital groups’ argument to the Appeals Court is that without the court allowing illegal cost-sharing subsidies, Obamacare will go into a “death spiral.”
