1. Health Insurance 2019: What’s changed and what has not
Kevin O’Connor
San Juan Basin Public Health

2. Questions?

3. What has not changed Insurance Carriers: Anthem and Friday
Tax credits to help pay premiums, rates will go down for many people
Cost Sharing Reductions are still available
Assistance is still available from Brokers, Health Coverage Guides, and Certified Application Counselors
Open Enrollment Period: 11/1/2018 to 1/15/2019

4. What has changed
La Plata Family Centers Coalition and Pinion Project in Cortez will not be providing enrollment assistance
Funding for Health Coverage Guides down 20% (going down additional 20% in 2020)
Simplified financial application system for Connect for Health Colorado
No Shared Responsibility Payment (aka tax penalty for not having a Qualified Health Plan)

5. What has changed, cont’d:
Short term policies extended to 364 days by Federal law
Association plans allowed and expanded by Federal law
State law is not over-ruled, Colorado has more limits so far
New short term and association plans have not been created yet
Brokers are allowed (but not required) to charge fees

6. Short Term policies The Good The Bad
Usually significantly lower premium than Qualified Health Plans through Connect for Health Colorado
Not eligible for tax credits
Subject to underwriting
Policy ends after 6 months, not renewable but you can reapply one time
Preventive care not always covered 100%
Limitations and exclusions
Payout limits
Right of rescission

7. Don’t take my word for it
“Short-term plans are cheap for a reason - they typically exclude pre-existing conditions that people have and they can cap the amount of coverage they provide,” said Colorado Insurance Commissioner Michael Conway. “Because many people will need more coverage than these plans offer, what consumers end up paying out of their own pocket could easily surpass any savings from low premiums.”

8. Association Plans The Good The Bad
Sometimes significantly lower premium than Qualified Health Plans
“Associations” has a broad definition, which increases availability
Not eligible for tax credits
Not everyone will have access
Subject to underwriting
Preventive care may be limited
Limitations and exclusions
Payout limits
Right of rescission

9. Don’t take my word for it
The need for more affordable coverage is real, but there are plenty of reasons to be wary of association policies. Their dismal track record through the years hardly suggests they’re a cure for our insurance system’s ills. Their return signals a resurrection of the Dark Ages in American health insurance and that old consumer warning, “buyer beware.”
Trudy Lieberman, Center for Health Journalism.

10. What does it all mean?
End of tax penalty expected to have relatively little effect
Short term plans still are not a solution to high rates
Association plans will be a mixed blessing at best
Brokers’ fees are still an unknown factor
Despite funding cuts SJBPH will provide help as always
APTC changes means people on basic plans may pay less and Gold plans may be a better choice than Silver for some