Texas Well and Healthy

But, I Like My Health Insurance Plan…Will Health Reform Make Me Change?

Dear Cheasty,

If my employer offers a pretty standard level of health insurance, will there be any changes to my plan when health reform is implemented in 2014? Do I get to keep that insurance plan if I like it? Will I see any benefit as an ‘average insured American’ who receives employer sponsored coverage?  Thanks!

Anxious in Austin

Dear Anxious,

Great news for you, my dear. When it comes to your particular health insurance situation, you can relax. The Affordable Care Act (a.k.a. health reform) includes a number of provisions that not only protect your current situation, but also improve it, at no cost to you.  Any way you look at it, for the “average insured American,” health reform is a win-win.

Here’s the first reason why you don’t have to worry:

Most Americans are covered by employer-sponsored health insurance, and that will remain true even after Obamacare goes into full effect in 2014. So if you and your employer like your plan, you can keep it.

And here’s even better news: the ACA will actually improve the plan you have in a number of ways.

First, the ACA has already ended lifetime limits and restricted annual limits on medical care. Second, if you have kids, the law rules that older kids can remain on their parents’ insurance until they are 26 years old – a great relief for a lot of young folks and their parents.  That benefit is also already in effect.  Third, if your insurance group has people with pre-existing conditions, your group is currently charged higher premiums and your coverage likely has a pre-existing condition “exclusion” that limits what the insurer will cover. These pre-existing condition exclusions will be gone in 2014. You will no longer pay more based on health status and your coverage will expand if you have a pre-existing condition.

So, Anxious, as you can see, a couple of changes have already improved your plan. But wait, there’s more!

If you aren’t the biggest fan of your health insurance plan, you may have other options. Let’s say you didn’t really like your insurance plan. Well, if you spend 9.5% or more of your household income on health insurance premiums, you can remove yourself from your employer’s plan and, taking your premium money with you, you can go purchase health insurance on the private insurance Exchange, where you would have a range of options and perhaps even access to cheaper prices (depending on how much you earn). Better coverage at a cheaper price?  Win!

Well, I hope this helps you relax about your coverage, Anxious in Austin. If you like your plan, you can keep it. If you don’t like it, you may have other options. Either way, Obamacare makes sure that you have as much power as possible – way more than you do right now – over your personal health insurance situation.

To a well and healthy Texas,

Cheasty Anderson
Center for Public Policy Priorities

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