People with health insurance purchased through their employer could see slower or no growth in their health insurance premiums and a reduction in benefits under the new Trump administration.
The idea is that health insurance would cost less for workers and employers if there were fewer required benefits, according to Rich Daly, a senior editor at the Healthcare Financial Management Association.
“The cost of commercial insurance has reached historic highs,” Daly said. “Even after the premium is paid, half of American families still owe average deductibles of $4,000-6,000 … before a penny of insurance starts covering anything.”
Republicans’ stated goal, according to Daly, is to help employers save money by eliminating the requirement to cover the cost of certain essential health services. That requirement was part of the Affordable Care Act and includes services in 10 categories including the following:
- Outpatient services
- Emergency care
- Hospital inpatient care
- Maternity and newborn care
- Mental health and substance use disorder services including behavioral health treatment
- Prescription drugs
- Rehabilitative care
- Laboratory services
- Preventive and wellness care and chronic disease management
- Pediatric care
“[These services are] costly, and they can include things people may not want to pay for,” Daly said. “It’s a trade-off, so if there are fewer things [employers are] required to cover, they may drop coverage of some things some employees want.”
It is not clear which types of federally mandated coverage benefits may no longer be required in coverage plans.
Any changes are likely to not kick in right away but people with coverage through their employer should keep an eye out for drastic changes to their plan, Daly said.
“If these changes go through, employees should make sure to track their own employer’s coverage to see next year, are there coverage changes that drop something they’re counting on,” Daly said.
For more on this, visit healthcare.gov.