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With deadline approaching, coverage through health insurance law uncertain beyond 2017
Incoming president, congress promising changes to Affordable Care Act
Doug Collins.2015
Collins

Key health care dates

Thursday: Deadline for new federal marketplace customers to apply for insurance to start Jan. 1. Those interested should go to healthcare.gov

Dec. 31: Current federal policies expire

Jan. 1: Beginning of new policy year

Jan. 31: End of open enrollment in federal marketplace

April 15: Deadline for federal income tax returns, which will charge a penalty for the first time on those without insurance the previous year

Thursday is the deadline to sign up for health insurance through the federal Affordable Care Act, if you want coverage starting Jan. 1.

But that’s about the only thing certain about the federal law going forward.

“It will be in place for the next year,” said Charles Bullock, University of Georgia political science expert. “Beyond that, we’ll have to wait and see.”

The law was the centerpiece legislation of President Barack Obama’s administration, but President-Elect Donald Trump has vowed to repeal it — and he has the backing of a majority Republican Congress.

“The election of Donald Trump is inherently the end of Obamacare,” U.S. Rep. Doug Collins, R-Gainesville, said in an interview last week.

“The process in getting (rid of) a good bit of the Obamacare spending and the taxing … will hopefully be one of the first pieces of legislation the new president will sign,” he said.

“Other parts, we’ll need to do in policy … as we move forward in transitioning away from the mandates and other things.”

One of the bill’s most hotly contested aspects was the requirement that Americans have insurance or face a tax penalty when they filed their federal returns.

Collins said the mission then becomes “how do we transition to a patient-centered, doctor-centered health care (system) that takes care of pre-existing conditions, family members staying (covered) until they’re 26, those kinds of things.”

The number of Hall residents currently on insurance through the Affordable Care Act couldn’t be determined. But, 17.6 percent of residents remained uninsured in 2014, according to the latest census figures, or about 33,281 people.

That’s down from 20.7 percent, or 35,548 people, in 2013.

The county’s uninsured rate, however, is higher than averages for the state, at 15.8 percent, and nation, at 10.4 percent.

As an advocate for health care consumers, Georgians for a Healthy Future is keeping a close watch on how things play out with health insurance in the new administration.

“We think it would be best to replace the Affordable Care Act before repealing it,” said Laura Colbert, the group’s director of outreach and partnerships.

“We have some concerns as to what would happen to the insurance market if there’s a lot of uncertainty for two or three years while Congress debates how to replace it,” she said.

“And, for us, we would really like to see a lot of the rights and protections that consumers have gained through (the law) maintained,” Colbert said.

That should include protections against discrimination involving the LGBT community and those whose native language isn’t English, she said.

As for removing the individual mandate, Colbert said that insurance companies could suffer the backlash.

“It would be hard for an insurance company to have a viable business if we still required them to issue health insurance to anyone who applied and maintain other protections, without some kind of enforcement that encourages young, healthy people to buy health insurance,” she said.

If the mandate goes away, “the question becomes how do you pay for” the law’s more popular components, such as children being able to stay on their parents’ policy until 26, Bullock said.

“All insurance policies work off the notion that you have the funds available for those who really need it, but they’re paid for by people who aren’t going to need it,” he said.

Rob Fowler Jr., executive vice president of Gainesville insurance firm Turner, Wood and Smith, has kept a close eye on the Affordable Care Act as it has evolved through Obama’s administration.

His firm has helped sponsor an annual Greater Hall Chamber of Commerce look at the law.

“Ever since the law passed in 2010, Republicans have campaigned on a pledge to repeal President Obama’s signature domestic policy achievement,” he said. “Trump’s victory, with continued GOP control of Congress, gives them their first opportunity to do so.”

To do a complete repeal and replace of the law, the Senate requires 60 votes, and eight Democrats would have to vote with all 52 Republicans, Fowler said.

“In my opinion, that is not going to happen,” he said. “The Republicans can repeal parts of ACA that are budget-relevant.”

Tom Price, the nominee to head U.S. Health and Human Services, is an advocate for a strong private health insurance market, Fowler said.

“Price has outlined a key issue will be buying coverage across state lines, causing insurance carriers to scramble on how it will impact them,” he said.

Even though ACA insurance likely won’t be disrupted in 2017, that doesn’t mean everything is rosy for potential consumers.

Hall County will likely lose half its current insurance providers within the Affordable Care Act marketplace next year, according to an analysis by the Kaiser Family Foundation. The move would affect about 10,400 residents who buy individual exchange coverage.

For Fowler, moving forward, he said his firm is “trying to focus on the various ways the proposed changes could impact our clients’ health plans knowing the changes could have a huge impact on the health insurance industry.”

But in the end, “it is unclear what changes to the ACA law will actually be implemented,” Fowler said.

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