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ACA January_2020

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Volume 3, Number 4

IN THIS ISSUE...

ACA’S INDIVIDUAL MANDATE RULED UNCONSTITUTIONAL

FIDELITY’S PULSE ON HEALTH CARE

ACA OPEN ENROLLMENT HAS ENDED

AMERICANS STILL HAPPY WITH PRIVATE HEALTH INSURANCE

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Latest News and Updates

The Fifth Circuit Court of Appeals ruled on December 18 that the individual mandate provisions of the Affordable Care Act are unconstitutional but refrained from invalidating the entire law and remanded the case to the District Court in North Texas to determine what parts of the law are inseparable from the individual mandate provisions and should also be ruled unconstitutional.

The ruling will NOT affect 2020 ACA plans, and it is not expected that the ruling will have any impact until at least 2021, if not later.

ACA’S INDIVIDUAL MANDATE RULED UNCONSTITUTIONAL

Until 2019 the Affordable Care Act imposed a tax penalty for not having health coverage that complied with requirements of the law (this provision is referred to as the “individual mandate”). When Congress amended the law, they left the individual mandate in place but imposed a tax penalty of $0 for noncompliance.

On December 14, 2018, Judge Reed O’Conner of the Northern District of Texas ruled that the ACA's individual mandate "can no longer be sustained as an exercise of Congress's tax power." O'Connor then struck down the ACA in full, concluding that the individual mandate is so connected to the law that Congress would not have passed the ACA without it. His ruling, however, left the ACA in place pending an appeal to the Fifth Circuit Court of Appeals.

On December 18 the Fifth Circuit agreed that the individual mandate is unconstitutional. Instead of agreeing to strike down the entire law, however, they remanded the case to the North Texas District Court to rehear the case and determine which parts of the law are inseparable from the individual mandate. The District Court’s decision ruling would then be reviewed by the Fifth Circuit.

Implications of the Decision

The Fifth Circuit is unlikely to overturn the ACA in full but could strike down parts of the law directly related to the individual mandate, such as the 3:1 ratio age band, under which insurers can't charge older members more than three times what younger members pay (until the ACA was passed 42 states permitted 5:1 ratio age bands) and prevention of insurers from varying premiums within a geographic area based on gender, health status or other factors. (The law’s prohibition from rejecting anyone with a pre-existing condition is expected to remain in force but it is possible that the pre-ACA practice of premium rate-ups for certain conditions could be re-instated.) If these parts of the law are ruled unconstitutional, premiums for ACA plans could change significantly.

Legal experts predict the earliest any additional court action will take place on the case will be after the 2020 elections, so existing ACA insurance coverage will remain in place until at least 2021, and probably longer, particularly if the Supreme Court agrees to hear the case on appeal from the Fifth Circuit.

The ACA is still in place and benefits under 2020 policies cannot change mid-year regardless of any court ruling.

We’ll keep you updated as more information is available.

Read this article for more details.

FIDELITY’S PULSE ON HEALTH CARE

Health care can be complicated – from health plans to Health Savings Accounts (HSAs) – and everything in between. Fidelity has created easily digestible material to make the transition to health care consumerism a little easier. Although the information focuses on employer-provided plans, much of the material also applies to individual plans as well. The collection of educational materials is aimed at the common misunderstandings of topics like HSAs and helping individuals make better decisions with their health care dollars.

Please click on the above graphic to open

ACA OPEN ENROLLMENT HAS ENDED

ACA open enrollment has ended, except in these states that operate their own exchanges: CO, CT, NY, and Washington, DC (January 15); MA (1/20); and CA (1/31).

If you missed the Open Enrollment Period and do not qualify for a Special Enrollment Period (SEP) , you’ll have to wait until Open Enrollment begins for 2020 (expected to be November 1, 2020) to buy an ACA plan for 2021. You can qualify for an SEP if you’ve experienced a qualifying life event that prevented you from meeting the enrollment deadline. Qualifying life events can include:

The loss of health insurance through a job or Medicare eligibility.
Household changes such as marriage, divorce, a death in the family, or having a baby.
A change in your home address.

You can see a full list of qualifying life events here . You have 60 days to enroll in a plan if you qualify for an SEP. But, if you miss that 60-day window, you will have to wait until OEP begins for 2020 to get an individual ACA health insurance policy.

Short-term health insurance, limited benefits health insurance plans, and medical cost sharing are also available on a year-round basis. Please call us at 561-734-3884 or 877-734-3884 to determine if you qualify for a special enrollment period or if you can qualify for one of these other plans. Generally, short-term health insurance. limited benefits health insurance plans, and medical cost sharing have pre-existing condition limitations and may disqualify you from purchasing coverage if you have certain conditions. Again, please call us for details.

AMERICANS STILL HAPPY WITH PRIVATE HEALTH INSURANCE

Some 71% of Americans rate their private coverage as "excellent" or "good," according to the latest Gallup poll, released December 9.

The share has remained constant in recent years, even though 2020 presidential candidates like Bernie Sanders and Elizabeth Warren ramped up their attacks on the industry in 2019. Both are pushing "Medicare for All" proposals that would essentially eliminate private coverage and shift the country to a government-run health insurance system instead.

Gallup poll results released December 4 showed that Americans continue to prefer a health care system based on private insurance over a government-run health care system by a 54% to 42% split.

The results, however, differ widely based on party. Some 65% of Democrats, on average, have favored a government-run system, according to Gallup polls from 2015 to present, but only 13% of Republicans do. Some 46% of independents, on average, prefer a government-run program.

Read the entire article here .

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HEALTH

DENTAL

MEDICARE

DISABILITY

LIFE

2020 Schedule
Affordable Care Act Open Enrollment

Open Enrollment began November 1, 2019 and ended December 15, 2019
on the federal facilitated marketplace for plans to start January 1, 2020.

Before the next open enrollment period starts you can only enroll
for an Affordable Care Act plan if you have a qualifying life event.

You may be eligible to enroll for another type of plan.
Call us at 561-734-3884 or 877-734-3884 for details.

2020 Schedule
Medicare Annual Enrollment Period

Annual Enrollment began October 15, 2019
and ended December 7, 2019 for a January 1, 2020 enrollment.

You’re eligible to enroll now if you’re first becoming eligible for
Medicare or are eligible for another type of enrollment period.
Enrollment rules differ between Medicare Supplement plans and
Medicare Advantage, Medicare Advantage Prescription Drug,
and stand-alone Prescription Drug Plans.

Call us at 561-734-3884 or 877-734-3884 for details.

Get Rates & Plans Now

family consulting

We offer a comprehensive set of Affordable Care Act (“Obamacare”) plans

to individuals and families qualified to buy health (tax- and non-tax subsidized) insurance and dental/vision and/or hearing plans through the Federal marketplace (this is called buying “on-exchange” or “on-marketplace”) or directly from insurance carriers (this is referred to as buying “off-exchange or -marketplace”). Our Affordable Care Act policies comply with the Affordable Care Act and contain all of the “essential health benefits” required by that law.

The dental/vision and/or hearing insurance

products are available both on an insured or discount basis

We offer short-term health insurance policies

for those who are looking for more inexpensive coverage and shorter term alternatives.

We offer Medicare Supplement, Medicare Advantage, and Part D Drug plans

to Medicare beneficiaries. Our site is compliant with federal, state, and carrier guidelines in selling these policies. See the Medicare section of this site for details.

We represent many carriers that offer supplemental benefits

to both individuals and families and Medicare beneficiaries, and the site contains information about hospital indemnity, cancer, critical illness, gap, accident, and international medical insurance offered by many different carriers. This section of the site also contains valuable information and tools about lowering the cost of prescription medications. Call us if you want more information about or would like to enroll in one of these products.

We also offer Short- and Long-Term Disability products

and can also help you meet the costs of long-term care, nursing home, or short-term (recovery) care needs.

Finally, we have a complete array of Life, Final Expense, and Annuity products

and offer pre-need services in Florida, as we have both life insurance and pre-need licenses in that state.

You pay nothing for our services:

we’re paid directly from the carriers we represent, Premiums are NEVER EVER marked up to include paying us for our services: you pay the same whether you order directly from the carrier or the marketplace on your own or directly through us or from our site.

We ONLY offer alternatives that are suitable for you and for which we feel meet YOUR needs.
When or if we feel a product or service is not appropriate for you from either a cost or benefit point of view we will tell you so.

We’re fully compliant with privacy and security guidelines, have signed all required privacy and security agreements, have developed a privacy and security policy, and take extraordinary steps to safeguard your protected health and personal information.
In short, we’re experts in all aspects of health and life insurance and also have relationships with professionals who can help you with very specialized situations.

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