How repeal of the Affordable Care Act could affect you

Marshfield Clinic Health System and its patients -- including Security Health Plan members, employers, agents and providers -- may be affected by possible changes to the Affordable Care Act that federal legislators voted on today. Our employees, customers and others will have questions about the effect of the changes on them.

We know many people are concerned how their health care and coverage could change. We do not believe changes will affect current year health care or insurance benefits, but are monitoring legislative activities and will react appropriately to any changes that occur. We will update this Q&A when we have new information to share about changes that could affect you.

Key takeaways
  • The U.S. House of Representatives on May 4, 2017, voted in favor of the proposed American Health Care Act (AHCA) to replace portions of the Affordable Care Act (ACA), under which more than 30,000 individuals and families now receive coverage through Security Health Plan.
  • The approved legislation will, in its current form, have a substantial negative impact on many people Security Health Plan and Marshfield Clinic Health System serve, including those in rural areas, the elderly and economically disadvantaged.
  • The AHCA replaces the income-based tax credits of the ACA with fixed, age-based tax credits. Generally, these fixed, age-based tax credits cause lower income and older enrollees to pay more for their health insurance on a monthly basis, in particular people in areas of the country where health care costs are highest, which are often rural.
  • As many as 98 percent of Security Health Plan’s individual and family plan members receive subsidies to cover the cost of their health insurance on the exchange. Additionally, nearly 60 percent of these enrollees are age 50 or older and would be subjected to higher premiums through the AHCA’s premium setting provisions.
  • Security Health Plan and Marshfield Clinic Health System do not support the proposed American Health Care Act, and have urged law makers in Washington to vote “No” on this legislation.
  • The bill passed by Congress will go to the Senate for consideration and possible revision. We continue to urge legislators to retain provisions that would strengthen health coverage for people near poverty. We also urge them to allow sufficient time to implement changes, and to not disrupt coverage our members already have, and coverage for 2018. 
What changes are proposed by the AHCA legislation?

Among the changes introduced by the American Health Care Act:

  • Tax credits will continue, but will be based on age, rather than income. This is an advantage for young people who have good paying jobs. It is less advantageous to low-income people over age 50.
  • AHCA repeals Medicaid expansion and replaces it with per capita block grants in 2020. This means fewer people might be eligible for Medicaid benefits, depending on how states use the block grants.
  • Health Insurance companies can charge more in premium based on age than they could under the ACA. Age rating goes from a 3:1 ratio to 5:1 in 2018
  • Insurance companies can charge an additional 30 percent premium to people who do not keep continuous coverage in small group and IFP markets
  • People with pre-existing conditions may need to get coverage through high-risk pools states may offer to people who do not qualify for individual coverage through the AHCA.
  • Actuarial value requirements (metal tiers) are eliminated
  • States may request waivers to reduce or eliminate essential health benefits on individual and family coverage.
What do you expect to happen next?
  • Following the vote in Congress, the Senate is expected to make a number of changes to the proposed legislation.
  • We continue to emphasize the need for market stability, the need to keep premiums affordable for those who are now receiving subsidies to pay for their coverage, to keep as many people insured as possible, and to allow time for changes to take place to help ensure a smooth transition for consumers and insurance companies.
How can I stay informed about changes that affect me?
  • We will update this Q&A with new information and post updates to our Website and Facebook page
  • We will keep Security Health Plan agents, employers, providers and members informed by mail of any formal changes that will affect contracts or coverage
  • Marshfield Clinic Health System patients can:
    • follow MCHS and Security Health Plan on Facebook (we will post links to trustworthy information)
    • watch for MCHS leaders in local news coverage of ACA changes.
    • Keep an eye on news sources you trust.