PracticeLink Magazine

Winter 2019

The career development quarterly for physicians of all specialties, PracticeLink Magazine provides readers with feature articles, compensation stats, helpful job search tips—as well as recruitment ads from organizations across the U.S.

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32 W INTER 2019 ▼ T HE Qu AL I T y O f L I f E ISS u E D E P A R T M E N T S Reform Recap Changes in the market for health insurance The employer-based insurance market has been stable for the last few years, but public exchanges less so. Physicians' fees may be affected. M o S t a M e R i C a N S R e C e i V e H e a lt H i N S u R a N C e t H R o u G H e M P l o y e R - SP o NS o R e D PR o GR a MS. That market has been stable in recent years. For the last six years, the increase in the cost of employer-sponsored insurance has been "relatively modest" according to the 2017 Employer Health Benefits Survey conducted by the Kaiser Family Foundation and the Health Research & Educational Trust. In 2017, the typical annual premium increase was 3 percent, and the average premium for family coverage was $18,764. Although the total cost of insurance has remained stable, more of the cost has shifted to workers. In 2012, workers paid 14 percent of the cost of family coverage; in 2017, workers paid 32 percent of the cost. Generally, people covered by small companies pay more to cover their families than people covered by large companies. The difference is $1,550 per year according to the Kaiser survey. The cost difference results from the proportion of premiums paid by employers and from the deductibles that are paid by employees and their families. Insurance exchanges President Trump did not succeed in repealing the Affordable Care Act (ACA), often referred to as "Obamacare." President Trump and Republicans, however, have pursued multiple policies that undermine the ACA, including the insurance exchanges that offer health coverage for people who do not have access to health insurance through employers, Medicaid or Medicare. Under the ACA, a penalty was assessed against people who didn't acquire health insurance. President Trump has directed that penalties no longer will be assessed. The tax penalties, which were upheld by the u .S. Supreme Court in 2012, served as incentive for all people to obtain insurance. That broadened the risk pool and helped reduce the cost of insurance per person. When people are no longer mandated to acquire insurance, some people will not— particularly if they view themselves as healthy and less likely to need insurance. That leaves sicker people in the insurance pool, and the cost of insurance per person goes up. J eff at K i NS o N

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