Predicting Future Health Insurance Trends

Updated November 6, 2019

The November 2018 election results will undoubtedly bring new opportunities to the individual health space. Voter turnout was at a record high which shows consumers are very engaged. Thirty-six percent of eligible voters voted in the 2014 mid-term election and 113 million voted in this mid-term election, that’s nearly 50% of all eligible voters. Health care and health insurance was the #1 issue for voters in 2018 with 41% of voters stating health care to be the most important issue facing the country.

Did you know?

Short term health insurance is now available for up to 364-days in many states, and the penalty for not having a qualifying health plan such as short term medical has been eliminated by the current administration and is no longer law as of January 2019. 

The fact that Democrats regained control of the House of Representatives is not as significant as many believe. The predictions have been that there will be a lot of investigations, many proposals to create a Medicare for All, and much rhetoric. Experts believe what is left of the Affordable Care Act will not change because the Republicans control the Senate and The White House. The political rhetoric for change that was the narrative of the midterm campaigns most likely will not happen.  The penalty for not having Obamacare will not be restored and subsidies for those buying Obamacare plans will likely not change. Medicare will also not be expanded.

The biggest impact to health care will be that seven Republican governors were displaced by Democrats. In six of those states — Wisconsin, Illinois, Maine, Michigan, New Mexico and Nevada — there will be Democrat-appointed insurance commissions. (Kansas elected a Democrat governor but also elected a Republican insurance commissioner). Because the Trump administration has made it easier to seek state-based waivers from Obamacare (called 1332s) it has been expected that many “red” state Republican governors will seek to expand short term medical plans and knock back Obamacare.  However, in at least six former Republican states, the 1332 waivers will likely not take place. In addition, three Republican states approved voter referendums to expand Medicaid:  Nebraska, Utah and Idaho. All are traditionally very Republican.

There may be small, bi-partisan reforms to health care in the following ways:

— change to Medicare by fixing the donut hole and Part D cliff

— funding to help farm associations create Association Health Plans

— a modest expansion of Health Savings Accounts

Health care will have a very high profile in the media, so what does this mean for the health insurance community? Below are a few takeaways.

  1. No big change to the market for our services. There will be a few more consumers that are eligible for Medicaid. A few more states may regulate short term medical health insurance. But the market for people buying their own health insurance—and the need for information on buying health insurance—will still grow, as expected.
  2. There will be more health plan “variations” as more control is shifted to the states.
  3. There will be more attention to “bad actors” in the insurance market. Insurance agents and carriers that don’t serve consumers in high-quality ways will be ousted.  Pivot Health will continue to monitor state regulatory and legislative plans.
  4. The financial markets are pleased by the outcome of the election because it won’t change tax policy in significant ways, and won’t change the fundamentals of health insurance in meaningful ways.

At the end of the day, the ACA is here to stay for awhile. It remains a solid option for individuals who qualify for cost-assistance through a subsidy and for those who have a pre-existing condition. But change is coming – we just don’t know when.