Changes to Health Care Over the Next Year

We all know that the Affordable Care Act will move forward so what will it look like? One thing we know is that the ACA predominantly addressed access to care not cost of care. This means that we will continue to see rates rise, at least for the near future. Why? As we talk to our clients and people in general the question is often raised; why are rates continually increasing?

Let us review. In California over the last two years we have seen the following: 1) Children can remain on their parent’s group plan until 26 years of age, regardless of student status. 2) Children, under age 19, have guaranteed issue. 3) Every plan must contain maternity benefits. 4)Women's preventative care covered at 100% - No copay, coinsurance or deductible for contraceptives as well as many other women's related issues. 5) Medical Loss Ratio as well as rebates for plans that don't meet them. 6) Expanded care for Autism. 7) Expanded Mental Health Benefits for all plans. This list does not include all the other internal reasons for the cost increases. Hospitals and Doctors have been mandated to change the way they deliver and report care. It has been a costly couple of years for them as well.

All of the above is what we have seen implemented. Over the next two years and for the following 4 years after that we will see many more policy changes take effect. From guaranteed issue to all to Insurance Exchanges and to fines for not participating these are just some of the things we know are ahead of us. What we don't know is what we don't know. As we write this, they are still writing the details of the law.

So what can be done to tame some of these costs? The mandate to buy insurance will help. The more healthy people paying and not receiving services will help contain some of the costs. We will also see a strong push to coordinate benefits with Medicaid and Medical (also referred to as Medi-Medi). In addition to these, we will see more Accountable Care Organizations (ACO's) taking shape. In theory the ACO's are designed to force doctors and hospitals to form networks that deliver more efficient care.
 
As always, if you have questions as to what all this means to you personally, please call us at (714)680-5900 or find us on our website at www.ansainsuranceservices.com . We will stay on top of any new regulations and clarifications in the health care laws.