New Health Insurance Changes Coming in 2016 in Wisconsin
The Affordable Care Act (ACA) has been law since 2010, but each year has brought new health insurance changes. First, the implementation was meant to take place during a number of years. Second, some revisions have been added. Some of the changes apply to employers, while others apply to people who purchased individual or family plans on the Health Insurance Marketplace or directly from health insurance companies.
I have to buy new health insurance – what new facts do I need to know?
- The penalty for not having insurance may more than double in 2016. For adults, the penalties increase from $325 to $695. For children, the increase is from $162.50 to $347.50 per child. Or, if the penalty is more by calculating 2.5 percent of your income above the tax filing threshold, that’s what you will pay, up to a maximum of $2,085. This fee is due when you file your 2016 taxes. It may actually be cheaper to get a new health insurance plan than to pay the fee.
- Premiums may have changed from 2015 to 2016. Even though the ACA regulates if health insurance companies may increase premiums in the new year, companies can still request permission to raise rates for increases of more than 10 percent. That means they can increase rates of less than 10 percent without having to ask the government.
- The good news is that in Wisconsin, 2016 silver premiums for a 40-year-old, non-smoker making $30,000 / year actually fell by 2.1 percent before the tax credit. The premium fell by 1.0 percent after tax credits were applied.1 It’s possible that you may actually pay less for new health insurance in 2016 than in 2015.
- If you bought a plan from an insurance company or through the Health Insurance Marketplace but didn’t re-enroll or buy a new plan, you may have a new health insurance plan anyway. Companies are allowed to move members on to a similar plan if the plan they were on in 2015 is no longer available. If this happened to you, you should have received a letter from your insurance company explaining the change. Be sure to review the letter so you understand your benefits.
- Individual grandfathered plans (those that existed before March 23, 2010) don’t have to comply with all parts of the ACA. However, if the plan significantly changes coverage, raises coinsurance or raises deductibles it may no longer have grandfathered status. That means that you need to find a new health insurance plan to avoid paying the fee for not having insurance that meets ACA requirements.
- Open enrollment dates may change. Currently, open enrollment for 2017 is proposed to take place November 1, 2016 to January 31, 2017.