Ways to Fix “unintended” Discriminatory Rules

Believe it or not, while unintended, there are many “Discriminatory Rules”, that were written into PPACA as Law, that have resulted in what most people would consider discriminatory practices.  The rules need to be addressed in order to make access to health insurance and healthcare more equitable.  The reality is that most people do not even know these rules are part of PPACA. 

These are a few short examples:

  • If an Employer offers a health plan to an Employee and the Spouse also has an Employer-offered health plan at their job, then, the Employer can “deny” the Spouse the option to enroll in the Employers health plan. 
  • If an Employer offers an Employee a health plan, the Employer can charge the Employee 100% of the Spouse’s cost of the health plan to the Employee to enroll the Spouse. 
  • English and Spanish are the primary languages, meaning if you speak another language, you will have a very difficult time finding someone to help you in your own language; and even the websites are typically limited to only English and Spanish. 
  • Separated Spouse Issues: Allow for Spouses to access Subsidy Tax Credits on an Individual basis, even if they are done on a pro-rated basis, as the current process makes it nearly impossible to for separated Spouses to access Subsidies.
  • Establish a New Subsidy Tax Credit Program that provides a Floor and not a Ceiling for getting a Subsidy, instead of the unmanageable sliding scales that we have today, a set amount would be better and easier to manage. 
  • Remove the ability for Employers to “Deny Employment” and to charge an extra “50% surcharge” for Smokers/Tobacco users.  This well-meaning approach means that people get turned away from jobs and Employer-based health insurance; and are less likely to buy a health plan due to cost, as the surcharge is not Subsidy eligible.  It is important to note that this applies to “any” tobacco use or smoker designation by an individual, to include Vaping, Medical Marijuana (considered smokers), Chewing, etc.
  • Fix the Medicaid eligibility rules to allow for an “opt-out” option, instead of forcing people into Medicaid.  Those that opt out should be eligible for the maximum Subsidy level available to purchase a health plan.  This would not force families to be split up between Medicaid and other health plans.  Medicaid should be an “option” for families and the self-employed.  Medicaid as an “opt in” option would allow self-employed people, gig economy workers, more health plan options.

The results would be more affordable health plan options with increased access to the healthcare system on a more equitable basis for all people; and in a much easier to understand system for choosing a health plan and accessing healthcare.