Bowen, Miclette & Britt Insurance Agency, LLC

Health Care Reform

Health care reform is again in the news. Due to the election of Donald Trump for President and the control of both the Senate and House of Representatives by Republicans, the likelihood for significant changes to the law - or outright repeal and replacement - is high. In the meantime, it is important that employer-sponsored plans keep in compliance with the current law – the Affordable Care Act – until such time as the law is amended or repealed.


Bowen Miclette & Britt is closely following the numerous Republican proposals*** being presented in Congress and will keep you updated on the most relevant information. At this time, there are a few key concepts that appear in most of the plans proposed by Republicans thus far:


  • Repeal of the individual mandate
  • Repeal of the employer mandate
  • Permit individuals to save more money for health purposes in a tax-advantaged way in health savings accounts (ie—increase the amounts per year that people may save) (possibly permit people to use HSAs even if they do not have a high-deductible health plan)
  • Permit the sale of cheaper insurance plans that do not provide as much coverage for those individuals who would like their health insurance to be a “catastrophic” plan or a “mini-med” (this entails removing the ACA mandates for certain types of coverage and certain levels of coverage)
  • Reduce or remove the employer tax credits for employer-sponsored health plans to encourage people to purchase from the individual insurance market
  • Alter rules at individual insurance market to provide “credit” for people who maintain continuous coverage, even though they may change carriers (this would offset any pre-existing condition exclusions that may be reinstated)
  • Create a federal tax credit for individuals of roughly $1500-$2500 per person for the purchase of health insurance premiums or to be deposited into an HSA
  • Permit insurance carriers to sell insurance “across state lines” to promote competition
  • Reduce the maximum amount a person’s income may be to qualify for Medicaid coverage from 138% of the federal poverty line to 100% of FPL (pre-ACA level) 
  • Change funding of Medicaid to each state from adjusted amounts per recipient to block grants


Other Provisions Proposed:

  • Give small employers more bargaining power by allowing them to join together to purchase coverage
  • Repeal guaranteed issue provision and replace guaranteed issue provision with either high-risk pools for those with pre-existing medical conditions, or a provision prohibiting insurers from denying coverage to individuals with pre-existing conditions, so long as those individuals had been continuously insured for the previous 18 months and if that continuous coverage was stopped, the individual would pay a penalty for each month without coverage up to the date of the renewed coverage
  • Transparency—require providers to publish specific cash prices for health care items or services
  • Permit states that like the ACA to continue to follow its provisions, while permitting those that don’t to stop



***The source of this information is the proposed plans of the following individuals:

  • President Trump’s team
  • Secretary of Health &Human Services Tom Price (presented when he was a Congressman)
  • Senator Rand Paul
  • Senators Susan Collins and Bill Cassidy
  • Speaker of the House Paul Ryan and House Republicans Committee
  • Congressman Pete Sessions