Here’s why you still need a 2018 health plan, despite Obamacare mandate repeal

Dec. 26--The GOP tax reform legislation, signed by President Donald Trump signed last week, includes repealing the Affordable Care Act's individual health insurance mandate in 2019.

Starting that year, there will be no tax penalty for those who choose not to have health insurance.

The repeal could result in the number of people with health insurance decreasing nationwide by 4 million in 2019 and 13 million in 2027, according to Congressional Budget Office estimates. At the same time, federal budget deficits would be reduced by $338 billion through 2027 because of the repeal.

Here are answers to some questions about the changes.

Q: Do I need health insurance for 2018?

A: Yes. The fee for not having health insurance will still be in place for 2018. Those who forgo insurance will pay a fee of either $695 for each uninsured adult and $347.50 for each uninsured child or 2.5 percent of your household income -- whichever is higher. That fee does not go away until 2019.

Q: Can I still enroll in health insurance?

A: Not through the federal exchange in North Carolina. The open enrollment period to choose a plan through the federal exchange ended Dec. 15, with 523,989 N.C. residents choosing a plan. However, there are special circumstances for those nationwide who were affected by the hurricanes last fall. Consumers can also enroll if they have a change in circumstances, called a qualifying life event. For example, if someone loses health coverage, gets married, has a baby or moves to a different zip code, he or she could enroll through a special enrollment. Consumers can also buy insurance directly from insurance companies.

Q: Will health insurance premiums increase?

A: Most likely. Consumers who purchase insurance on the nongroup markets (through the exchange or directly from insurers) could see premium increases by about 10 percent in most years of the next decade, according to CBO estimates. That would occur because healthier people would be less likely to get health insurance. Those higher premiums would also cause more people to forgo health insurance.

Q: Will subsidized health plans still be available?

A: Yes. Federal subsidies help lower the cost of premiums, making the insurance plans more affordable for low-income residents. Of the roughly half a million N.C. residents who had Affordable Care Act insurance plans in 2017, nine out of 10 received financial help paying for their health insurance. The other 10 percent cover the full cost of their health insurance premiums, which can cost thousands of dollars a year.

Q: What will happen to other parts of Obamacare: Preexisting conditions? Coverage for kids up until 26?

A: Other aspects of the Affordable Care Act that will stay include:

-- Allowing children to stay on their parents' insurance plans until they turn 26 years old.

-- Prohibiting insurance companies from denying coverage based on preexisting conditions.

-- Requiring health plans to cover preventative services, like shots and screening tests, at no added cost to the consumer.

Cassie Cope: 704-358-5926, @cassielcope

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