The Effects of Affordable Care Act Marketplace Uncertainty on Healthcare Costs

After Senate Republicans failed to repeal ObamaCare, Americans continue to ask what all this means for the Affordable Care Act Marketplace. Some people want a repeal, but others would rather have the administration support the existing system until a new and better one is designed. The precariousness of the Affordable Care Act (ACA) for the coming years bears impending negative impacts.

Higher Premiums

Uncertain about what will happen to the ACA marketplace, insurers are preparing for a spike in rates. A few months ago, several insurance companies reported the possibility of policy price increases when it’s purchased outside the marketplace. Maryland residents were told to prepare for a 50% hike, while Connecticut could experience 34% payment increases.

How to Manage Uncertainty in the Affordable Care Act Marketplace

The problem can worsen due to the possible reinstatement of a health insurance tax which was suspended last year. The tax was a component of ACA in 2010 and aimed to fund the expanded coverage for around 800,000 Garden State residents. The tax was planned for implementation in 2018.

A health insurance tax may add hundreds of dollars each year to an individual’s policy. It will add $250 a year to the cost of policies for seniors and disabled residents, and more than $550 per family for small business owners. Families with large businesses would pay more than $600. The state would also have to pay $270 more for every Medicaid member.

In the meantime, while insurance companies shouldered the federal fee, the cost of ACA, which may reach $22 billion in 2018, will be passed on to its more than 100 million insured holders. Some Republicans want to remove taxes connected to ACA, but the premium fee is still scheduled for application which will raise policy payments.

Additional Out-Of-Pocket Expenses

Around 130,000 Marylanders who purchased ObamaCare plans are anxious. Lisa Eimer, a charter school executive assistant in Baltimore, is already paying $440 a month for her policy which is why she avoids filing a claim. She prefers to pay for health care services on her own which increases out-of-pocket expenses in the long run.

More Uninsured and Underinsured

If the people can’t afford their health insurance premiums, this will drive the number of uninsured and underinsured to new heights. Those who are already struggling will settle for the least insurance coverage or forego it altogether since the cost of paying the uninsured penalty is much smaller than the monthly payments. In effect, the uncertainty about what will happen to ACA can multiply healthcare problems and costs.

To handle uncertainty in the ACA marketplace, consult with navigators to determine how you can help your patients access proper and affordable insurance options. Trained and prepared navigators can properly determine their eligibility and help them apply in the ACA marketplace so they can access a suitable health insurance plan that will pay for the medical services they need.


“Health Care Debate a Source of Anxiety for State's Obamacare Enrollees,”
“Obamacare Uncertainty Could Drive up Marketplace Healthcare Costs in 2018,”

Robert Griffin

Robert is the Business Development Manager at DECO Recovery Management. He covers the Southeast region and specializes in ACA related topics. It is DECO’s Mission to maximize reimbursement to our clients by leveraging innovative technology, processes and compassionate advocates to provide exemplary service.

Categories: Affordable Care Act