Effect on Patients and Businesses

The American Health Care Act rolls back individual requirements to carry health insurance.

Two provisions of the AHCA would be retroactive to December 31, 2015 include:

  • Individuals would not be penalized for being uninsured
  • The Act would eliminate the employer mandate to provide coverage without a financial penalty

Other provisions of the AHCA related to Individuals and Businesses effective various dates in the future include:

  • Insurance companies will be allowed to charge individuals up to a 30% penalty if an individual goes without health insurance for more than 63 days
  • The limit on deductible medical expenses on the tax return will remain at 7.5%
  • Eliminating the 0.9% increase in Medicare tax
  • Suspending the “Cadillac” tax for employers offering excessive coverage until calendar year 2025
  • Roll back the limit to flexible spending accounts
  • Allow over-the-counter medications for reimbursement under flex spending accounts, health savings accounts, Archer Medical Savings accounts, and Health Reimbursement Arrangements
  • Change Federal Medicaid funding to states to a per enrollee cost
  • Many other detailed provisions not listed

Health care providers ask me what effects will they potentially experience? The health care industry will continue to see increasing costs. Eliminating the individual mandate providers will likely see an up-tick in the number of self-pay patients. Providers will need to consider how to discount charges (if at all) for self-pay patients while staying compliant with other payer contracts.

Concierge medicine is an emerging trend in providing primary and elective health care to patients. The concierge medicine concept allows patients to gain access to their preferred physician without scheduling barriers. Models such as concierge medicine gives an advantage to individuals and families who are in the middle to upper income levels. The roll back of Medicaid funds leads to questions about access to quality health care for individuals and families who are low to middle income levels and rural health. As the American Health Care Act unfolds, providers will need to adapt to fit the needs of the patients in their individual communities while keeping an eye on their reimbursements for the care they provider.

Katie Fergus will provide a free consultation discussion your practice and possible scenarios in this rapidly changing industry.  Contact Katie by email Katie@FinanSynergy.com or phone 515.635.5531. We look forward to hearing from you and welcome the opportunity to meet your needs.