Trump Won, Vows Day 1 Full Repeal. Lets Discuss.

[RayNY]

https://assets.donaldjtrump.com/HCReformPaper.pdf

"On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare"

Purchasing across state lines will be permitted.

There's also many un-mentioned but implied consequences. For instance, Small group goes back to 1-50 instead of 2-100, since that's an ACA change. APTC's won't exist for 2017, and how 2016 payments are handled is yet to be seen (might be ignored, might be considered income, might be clawed back). I'd assume that means basically all subsidized clients drop out, as I don't see them continuing APTC's after a full repeal. Guaranteed issue goes away (but it's state level in some places, like NY). Open enrollment no longer applies. Risk Adjustment no longer exists.

Assuming he follows through, effective February, we should have some interesting opportunities available. We should be able to re-market all groups and sole props or husband/wife clients to PPO plans from other states. Since the premiums, products, and underwriting guidelines are filed for the year, they're stuck with whatever business they get. The difference between low-cost and high-cost states can be massive. That's before we get into age banding and smoker rate differences.

So, which state has the cheapest small group PPO product?

 

[SamIam]

I think they will repeal it for 2018. They would have to get new plans approved in the states. There is no way you can toss this away in a couple of months. Pass it yes new plans, not until next year.

 

[Ann H]

I think they might pass a quick "repeal effective 12/31/2017" law, just to say they repealed it ASAP. But that is just a sucker punch, because there is so much pent-up anger.

But then the real thinking begins. There will be lots of voices, from insurers, businesses, doctors, pharmaceuticals, special interests, those supporting the poor, and the uninsurably ill, etc. Lots of thinking to do before we have a new law.

I don't expect a knee jerk reaction at this stage, because the probability of repeal/replace is very high. I expect a well fought-out solution. And that takes time.

 

[AllenChicago]

it will be dismantled in stages with a safety net for those who might be hurt by repealing Obamacare.

 

[Evan]

Gonna be funny when the voters for Trump lose their subsidies..

 

[HoosierLife]

Gonna be funny when the voters for Trump lose their subsidies..

you mean the large percentage of working-class whites they get their insurance through their employer??

 

[bill3173]

Gonna be funny when the voters for Trump lose their subsidies..

Interesting..most of the subsidy patients that I have were Hillary voters. I've found that the opposite is true of what is said in the Media. Most of the people that vocally supported Trump were educated white collar, and those that vocally supported Hillary were mentally disabled (some undiagnosed), or poorly educated and without stable incomes.

 

[Alston]

Gonna be funny when the voters for Trump lose their subsidies..

you mean the large percentage of working-class whites they get their insurance through their employer??

I can't count the number of people who complained about the ACA when I was helping them enroll. When I mentioned, as tactfully as I could, that under the old system they wouldn't qualify for any plan because they wouldn't pass underwriting they never missed a beat in their rant.

A larger and larger chunk of the working class of all races can no longer get coverage from their employer.

Very few employers are subsidizing coverage for spouses and dependents.

So I agree. A lot of Trump supporters will lose their subsidies if he gets what he says he wants.

In fact, my last MA sales call was at a house of a white family with a Trump sign on their lawn. The wife was aging out of a subsidized HIX plan into Medicare.

Since Connecticut is not a swing state, she told me that she might vote for Johnson in the end, but she did have that sign on her lawn.

 

[bill3173]

Losing subsidies? How about returning to the pricing structure we had in place before this stupid legislation was ever passed. I have people in their 60s paying nearly three times what a similar plan would cost Pre President President Obama.

They get a great 50% subsidy, so they are doing so much better only paying 150% of Pre President President Obama. Any Agent who sees this disgraceful assault on tax payers as something good is seriously misguided.

 

[LGilmore]

"So, which state has the cheapest small group PPO product?"

Do you really think pricing works this way? SMH

Premium pricing will still depend on the cost of care in a given zip. Just like auto, just like home.

There aren't going to be any plans that do what you seem to think. If so, it's a quick way out of business. Insurance companies price product by cost in the area they are selling too. They will not market products that guarantee them a loss from the get go. Think. Think. Think.

Do you think anyone is going to sell a product that undercharges consumers but overpays care providers? How long would they stay in business?

If you doubt me, look at how other insurance products are priced and why.

When they dump the ACA but prices don't go down, people are going to be pissed off. Until they address the cost of care, they will not be able to reduce price of premium.

They can just shift more risk to the consumer to drop premiums. That works for people until they have claims, then they're screwed if they chose a plan they can't pay for to use. I really don't think the GOP wants this baby, cause it's really only solvable by pushing more risk on the consumer.