Cross-Border Health Care Concerns with Trumpcare 2.0

As discussed in my last blog post, President Trump has been intent on repealing the Affordable Care Act (also known as “Obamacare”) and replacing it with a new health care plan. On March 24, his first attempt at repeal-and-replace fell apart when it became clear that the American Health Care Act (also known as “Trumpcare”) lacked necessary support in the U.S. House of Representatives.

On May 4, five days past the 100-day mark of his presidency, Trump and his administration narrowly succeeded at getting the House to pass a reworked version of the bill, nicknamed “Trumpcare 2.0.” From here, the bill will move on for debate in the U.S. Senate, its fate uncertain.

We take comfort that our Canadian clients planning to move to the U.S. enjoy guaranteed U.S. health care coverage because of Obamacare’s “Guaranteed Issue” provision that prevents insurers from denying coverage based on age or pre-existing conditions. While Trumpcare 2.0 technically preserves this popular provision, it offers weaker protection for those with pre-existing conditions.

In a compromise to appease the more conservative wing of the Republican Party, Trumpcare 2.0 does away with the “community rating” provision under Obamacare that bans insurers from charging sick people higher premiums. This provision requires insurers to charge the same premium to every customer of the same age in the same area.

Under Trumpcare 2.0, individual states would be permitted to opt out of this requirement as long as those states create a “high-risk pool” for those priced out of the regular market. Sicker people relegated to a high-risk pool would face far higher premiums. The trouble is that 35 states had high-risk pools in place before Obamacare, and those pools proved impractical due to unpredictably high costs.

While the fate of Trumpcare 2.0 remains to be seen, it appears that Canadians planning to move to the U.S. will continue to enjoy guaranteed eligibility for health insurance despite any pre-existing conditions; however, they could potentially face higher premiums depending on their health status.

Given the political instability in the U.S. health care landscape, we believe there is a better health care solution for Canadians planning to move to the U.S. To discuss this solution, please contact us and we’d be happy to review it with you.

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