GHB’s WA Healthcare Series: Part 1

In short, no, but it’ll still be wise to explore your options before going without coverage.

On December 22, 2017 tax bill H.R. 1 was signed into law.  Contained in the tax bill was the elimination of shared responsibility payment for individuals failing to maintain minimum essential health care coverage.

This amendment is not a repeal of the Affordable Care Act (ACA) or an elimination of the individual mandate altogether – it is simply a zeroing out of the penalty. In essence, it sheds the tax implications for folks failing to carry health insurance.

The amendments made to the individual mandate (zeroing out of penalty) go into effect starting in January 2019.  In short, you won’t be required by the IRS to have health insurance in 2019.  However, you are still required to carry minimum essential coverage in 2018 for 10-out-of-12 months or face a potential tax penalty for not doing so.

While, inevitably, there will be a segment of the population that will be relieved to see the penalty lifted for tax year 2019, we’ve already seen many Washingtonians choose to go without coverage on account of rising premiums and across the country, an increased number of young adults are choosing to live without insurance.

What does this mean moving forward?

As of right now, the ACA is still the law of the land.  You will have 45 days (November 1 – December 15) to select your health plan for 2019.  Individuals and families will not be able to purchase comprehensive health insurance outside that timeframe unless they experience a life qualifying event (losing employer coverage, getting married, having a baby, COBRA exhausting, et cetera).  That means if you get hurt or sick mid-year and are without coverage, you will open yourself to the potential risk of being on the hook for all associated expenses related to your illness.

In addition, Washingtonians will (if qualified) still be eligible for subsidies to help them pay their premiums, be able to keep their Washington Apple Health (Medicaid) and still not have to worry about getting denied coverage due to a pre-existing condition. Insurance carriers operating in the ACA markets still have guarantee issue.

What about the expansion of short term medical plans – can’t I have one of those plans for the whole year now?

While there has been much discussion around the enhancement of “skinny plans” (short term medical and association plans) being a long-term alternative to the comprehensive ACA plans, there has been a limiting effect in Washington State.  Short term medical plans will carry a maximum duration of 3 months, without the option to renew.

Association plans would offer Small Businesses some flexibility, enabling them to band together to create a pool.  However, Association plans still have several hurdles to clear before they become a viable market.

While you are no longer required to carry health insurance, you should consider all the alternatives before simply choosing to go uncovered.

Casey Meehan is GHB’s Individual Market Specialist and President of a Regional NAHU Chapter.