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Don't Bet on Big Health Law Changes When Mulling Coverage

Health experts say the threat of financial disaster, not the Affordable Care Act's hazy future, should shape any decision to buy coverage for next year



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    The threat of financial disaster, not the unclear future of the Affordable Care Act, should shape people's decision to buy coverage for next year, according to health experts.

    Why worry about buying health insurance when President-elect Donald Trump plans to dump the requirement that most Americans get coverage?

    For the same reason you should always worry about health insurance: Little health problems can easily turn into big bills without it.

    "The real risk is something will happen to you, and you won't be able to get care or (you) go broke trying to pay for it," said Karen Pollitz, a senior fellow at the nonprofit Kaiser Family Foundation. Pollitz recalls the time she saw the bill for surgery her son needed after breaking his wrist skateboarding: It would have cost $21,000 if insurance hadn't covered most of it.

    The threat of financial disaster, not the Affordable Care Act's hazy future, should shape any decision to buy coverage for next year, health experts say. Trump has vowed to repeal and replace predecessor Barack Obama's health care law, and the new president may begin doing so shortly after he takes over next month.

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    That process could take months or years to unfold, though. Meanwhile, your next big health care scare could strike Jan. 1.

    Here's what we know about the ACA's future as the annual open enrollment window for individual insurance winds down. Shoppers have until Dec. 15 to buy coverage that starts Jan. 1. Anyone who misses that deadline can still enroll by Jan. 31 to have coverage for the rest of the year and avoid a penalty for remaining uninsured.


    No changes are expected next year for the more than 10 million people covered through and state markets that offer subsidized private insurance. An additional 9 million low-income people covered by Medicaid in states that expanded the program also are safe, for now.

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    Trump has said he'd like to sign legislation repealing the law soon after his Jan. 20 inauguration, but that's unlikely. It will probably take months for Congress to act. Republicans, who will control Congress, also have discussed giving the law's beneficiaries a transition period of a year or more as they phase out Obama's law and introduce what they say will be a replacement.

    If they were to immediately cut funding, it would mean no insurance coverage for millions of people. That's a headache any new president would want to avoid, and Trump has said he wants to preserve coverage as he pushes for the law's repeal.


    No. The 2017 prices were set months ago, they have been approved by regulators, and they are being used in the market.

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    Customers can hunt for cheaper coverage on or off the ACA's public exchanges before the end of open enrollment.

    There are other cheaper alternatives, but they come with a catch. Raleigh, North Carolina broker Liz Gallops has been talking to some clients about short-term coverage that generally costs less — and covers less — than plans sold on the ACA's exchanges. These plans leave customers exposed to a fine for remaining uninsured, but they offer some protection from the hit of a big medical expense, which is the big worry.


    People who remain uninsured next year could face a penalty of $695 per adult or more, depending on household income. But they wouldn't have to pay that fine until after filing income taxes in early 2018. Trump has said he wants to dump this unpopular element of the law, so it may not exist by then.

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    Still, there's no guarantee.

    Gallops doesn't bother with speculation. She thinks the safest bet for customers is to simply "play by the rules that we have today."

    "Everything could change for 2017 or nothing could change," the broker said in an email.


    Enrollment for 2017 plans started Nov. 1, and about 2.1 million people have renewed coverage or signed up for the first time through Nov. 26 on, the federal website that handles insurance applications in many states. About 519,000 of those customers are new.