Changes that Confirm the Unfortunate State of Employer Health Plans in the Country

The Republican GOP bill that seeks to repeal and replace various important parts of the Affordable Care Act poses a real threat to the healthcare plans provided by the employers. About 154 million Americans who are younger than 65 years of age receive coverage through their work or a family member's employer. However, the number the people receiving health insurance is bound to drop following the permissive regulatory approach on the House Republican health care bill.


About ACA Insurance


A health insurance should focus on protecting the country's citizens from financial challenges that they would come across while seeking treatment. The Obamacare plan attempted to give the citizens an insurance coverage that they would all afford while at the same time protecting them from insurers looking to bar them from receiving the coverage by placing lifetime and annual limits. Additionally, ACA required an employer with less than 50 employees to provide at least ten essential benefits, which include preventive care, mental health and addiction treatment, maternity and newborn care. Other benefits that they should provide include pediatric care, habilitative and rehabilitative services, inpatient care, outpatient care, prescriptions, oral and vision care and the emergency services.


The Current State of Medical Coverage


The GOP revised plan comes with many changes with most employees losing their protection rights. The employers also have the liberty to choose whether to provide coverage or not. Some of the changes that come with the Republican Plan include:


1) It is no longer mandatory for the employer to provide coverage to their employees


The bill protects employers from fines that they would get under the ACA insurance is they did not give the ten essential benefits. Most people, especially those working in the small to medium companies, might lose their coverage from May 2017. Approximately seven million fewer workers are likely to lose the coverage under the new bill, but some of them will seek individual coverage while others will remain uninsured. The large companies competing for employees may tend to use that as an additional benefit to woo more workers to their enterprises.


2) The Insurers can charge higher premiums to the workers


Since there is a waiver of the penalties charged to any employer who does not provide at least ten benefits, most insurers may choose to increase the premiums for anyone needing broader coverage other than the ones set by their state of residence.


3) The insurers can now provide cheaper policies that have fewer benefits


This means, the young and healthy policyholders may choose to fewer benefits for a lower premium. However, this increases the out of pocket expenses in case of a service not indicated in your GOP plan. Any person with underlying medical conditions may require more coverage, which equates to higher premiums. Anyone at the age of 65 years and above and with underlying health problems should consider getting Medicare and Medigap plans to save on their premiums and out of pocket expenses.


4) The states to get waivers for some federal regulations laid by the ACA insurance


The state can determine the healthcare plans that the employer must cover, which is contrary to the previous federal mandated ACA plan followed by every state in the country. This means, the GOP plans for the Massachusetts may be different from the ones offered in New York.




The GOP supporters have received the news warmly since they feel that they would be spending too much by paying insurance premiums for ten benefits that they do not need. On the other hand, a big number of employees stand to lose their employer coverage that provided maximum protection to them and their family.


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