With President-elect Donald Trump set to take the White House in January along with a Republican Senate and likely a Republican House, major changes could be coming to the nation’s health care systems, including Obamacare subsidies, cuts to Medicaid for low-income citizens and changes to Medicare for seniors.
But for now things are relatively calm — if not increasingly expensive — as New Jerseyans begin to sign up for health insurance plans to cover 2025. Premiums are set to rise across the board for employer-based insurance, Obamacare plans and Medicare.
Health care costs for employer-based plans are expected to rise 5.8% on average per employee next year, even after accounting for cost-reduction measures, according to a survey by the consulting firm Mercer.
Story continues below photo gallery
It is the third year in a row that expenses will have risen more than 5%.
Several factors have contributed to the rising costs, from inflation to the rapidly-escalating cost of prescription medicine.
Health care worker shortage, expanding hospital systems raise costs
Demand for health care workers is very strong and job candidates can often command higher salaries and better benefits from employers desperate to shore up their workforce depleted in the aftermath of the COVID-19 pandemic.
New Jersey’s largest hospital systems continue to grow by buying up practices and negotiating higher reimbursement rates from insurers. They are also spending hundreds of millions to expand the physical footprint of their medical centers and offices.
While employer-based plans represent the biggest market in New Jersey, a growing number of residents are signing up for Get Covered NJ, the state government’s marketplace that offers private plans backed by the federal Affordable Care Act, commonly referred to as Obamacare.
Open enrollment began Nov. 1 and closes Jan. 31. via the website GetCovered.NJ.gov.
Like employer plans, rates for 2025 submitted by the six marketplace carriers — Aetna, Ambetter, AmeriHealth, Horizon Blue Cross Blue Shield, Oscar, and UnitedHealthcare — will increase by an average of 6.2%.
But state officials said there may not be any rise in premiums felt by consumers due to “historic levels” of government financial help based on their income. The average subsidy last year was $6,792 per person among the record 400,000 New Jerseyans who signed up.
Federal funding for health care a target for Trump, Republicans
With Trump promising tax cuts and Republican leaders vowing to tighten the federal budget, government-supported health care systems are a likely target. Trump has no outright a plan, but GOP lawmakers may not go back to the “repeal and replace” Obamacare movement of the first Trump presidency. Instead, they could reduce funding for subsidies dramatically.
Although there have long been talks in conservative circles about privatizing Medicare, it is not clear how much change would come to Medicare since it is very popular among seniors, a core demographic for the party.
Medicare Part B users will see their monthly premiums rise to $185 next year from $174 this year and will automatically be deducted from their Social Security deposits. The increase outpaces both inflation and the Social Security cost-of-living adjustment for 2025.
Medicare open enrollment began Oct. 1 and runs through Dec. 7 for those 65 years and older.
link