What You Need to Know About the “Protection from Obamacare Monopolies Act”

Republicans have introduced the “Protection from Obamacare Monopolies Act,” a bill that would exempt people residing in counties with fewer than 2 health insurance insurers offering plans on the Exchange from being assessed a penalty for not having qualified coverage. The penalty is currently $695 per person, or 2.5% of the household income – whichever is higher – if uninsured in 2016.

The Affordable Care Act (ACA), also known as Obamacare, was supposed to have provided an increase in plan availability and competition. Instead, there has been a rapid decrease in available health insurance networks across the nation. This trend is expected to continue, as large insurers leave the marketplace. Both Aetna and UnitedHealth Group have announced that they will exit the market in many areas due to higher than anticipated losses and lower than expected enrollment of healthy, younger adults.

Although the bill is not likely to pass this year, lawmakers on both sides of the aisle are becoming increasingly concerned over the lack of availability of network choices in many states.  Senator John McCain (R-AZ), one of the bill’s sponsors, announced that half of the counties in Arizona only have one provider offering coverage on the Exchange, leaving citizens with no way to shop their insurance coverage for premium savings. McCain and the other sponsors, including some Democrats, argue that it is not fair to penalize people by taxing them when they do not have any options.

Middle class people who don’t qualify for Medicaid, and seniors who don’t yet qualify for Medicare are particularly vulnerable to a lack of coverage availability. Most can’t afford, or are too ill, to travel far distances to access medical care. In some areas, there are no available marketplace health providers, meaning people have to travel more than 50 miles to see a doctor.

The Kaiser Family Foundation analyzed the Exchange options for the upcoming Obamacare Open Enrollment starting November, 1^st. They found that roughly 1/3 of American counties will only have one Obamacare option in 2017. In some states, there will be only one option in the entire state.