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Key Issues in Health Insurance Today and Solutions

Updated: Nov 1



health insurance certificate with a stethoscope


Health insurance is a crucial topic in the United States, and there are several key issues that are currently making headlines. In this blog post, we will discuss the top three health insurance topics in the US today and solutions that may apply.




1. Affordable Care Act (ACA) and its Future: The Affordable Care Act, also known as Obamacare, continues to be a major point of discussion in the US. The future of the ACA, including potential changes or improvements, is a topic of great interest and concern for many Americans. With ongoing debates about its effectiveness and potential revisions, the impact of the ACA on health insurance in the US remains a significant issue.


  • Since its implementation, the ACA has faced ongoing scrutiny and challenges, with discussions surrounding its potential revisions, improvements, or even replacement. With changes in political leadership and shifts in public opinion, the future of the ACA remains uncertain.


  • One aspect of the future of the ACA involves discussions about potential legislative changes. There are ongoing debates about the need for modifications to the existing healthcare law to address its perceived shortcomings and to better meet the evolving needs of the population. This includes discussions about the individual mandate, Medicaid expansion, subsidies for insurance premiums, and protections for individuals with pre-existing conditions.

  • Moreover, the future of the ACA is also tied to legal and judicial considerations. Ongoing legal challenges to various components of the ACA have raised questions about its long-term viability and sustainability. Court rulings and legal battles have the potential to shape the future of the ACA, impacting its implementation and the extent of its coverage provisions.

  • Furthermore, the future of the ACA is also influenced by public opinion and the perspectives of various stakeholders, including healthcare providers, insurers, and advocacy groups. The level of support for the ACA, as well as the identification of its perceived successes and failures, will play a crucial role in shaping its future trajectory.


  • In conclusion, the future of the Affordable Care Act is a multifaceted and complex issue, influenced by legislative, legal, and public opinion dynamics. As discussions about the ACA's future continue to unfold, it is clear that its impact on health insurance and healthcare in the US will remain a critical topic of debate and consideration for the foreseeable future.


2. Rising Premiums and Out-of-Pocket Costs: Another critical topic in health insurance is the increasing cost of premiums and out-of-pocket expenses for many Americans. As healthcare expenses continue to rise, individuals and families are facing financial challenges in accessing and affording quality healthcare. This issue has sparked debates about the affordability and accessibility of health insurance for all US citizens.


  • Unsubsidized premiums in the ACA Marketplaces are rising due in part to inflation. Premiums are rising by an average of 5% in 2024 for the second-lowest cost silver plan (the benchmark against which subsidies are calculated). Premiums for the lowest cost bronze plans (the least expensive plans on the Marketplaces) are similarly rising 6%. (State-level data are available here). An earlier KFF analysis of premium rate filings found the primary drivers of premium growth heading into 2024 are rising prices paid to health care providers, driven in part by inflation in the rest of the economy, and a rebound in utilization coming out of the pandemic. However, other factors like the reduced use of COVID-related care are having a downward effect on premiums. Although unsubsidized premiums are rising, the Inflation Reduction Act’s temporary enhancement of subsidies continues to make the vast majority of Marketplace shoppers eligible for financial help with the cost of coverage. These subsidies cap how much enrollees must spend on a benchmark silver plan premium as a share of their household income, meaning that most enrollees will be sheltered from the increases in the sticker price of the premium.


  • In general, the ACA requires non-grandfathered plans to apply an embedded OOP limit for everyone enrolled in coverage. Each enrollee must have his or her own individual OOP limit on EHBs that is not higher than the maximum self-only OOP limit. For example, if an individual enrolled under family coverage reaches the applicable ACA OOP limit for self-only coverage, that individual cannot incur additional OOP costs for EHBs, even if the family OOP limit has not been met.


  • For 2024, the ACA OOP limit for self-only coverage will be $9,450 (up from the current 2023 limit of $9,100), and $18,900 for family coverage (up from the current 2023 limit of $18,200).

3. Mental Health Coverage: The importance of mental health coverage within health insurance plans is gaining more attention. With a growing awareness of mental health issues and the need for comprehensive coverage, discussions about the inclusion of mental health services in insurance policies are at the forefront. Many are advocating for improved mental health coverage to ensure that individuals receive the support they need.


  • Finding Supportive Services

If you are interested in finding supportive services in addition to professional counseling, look for these options in your community:


  • Hotlines and Warmlines provide immediate support by telephone for people in emotional crisis and people with mental health conditions. Where hotlines provide emergency support and crisis intervention, warmlines provide assistance, comfort and referral services. Hotlines and warmlines can be lifesaving, they provide referral to help and care, and they are comforting because they are anonymous and easily accessible by telephone. 

  • Drop-in Centers are organizations that are generally run by people with mental health conditions for their peers.  A safe, accepting place to go for company and support. Drop-in centers may organize activities such as support groups or trainings, but they may also be more informal gathering sites. 


  • Support Groups may meet at various places in your community such as churches, schools or government buildings. You can find information about support groups on the Internet, on bulletin boards at local mental health centers and restaurants, or by asking other people with similar conditions. Some support groups also meet anonymously on the Internet, posting on forums or using e-mail to stay in touch. Support groups should either be free or should have a very low cost to cover food or activities ($5 a meeting). 

  • The American Self-Help Clearinghouse (https://www.mhselfhelp.org/) and the National Mental Health Consumers' Self-Help Clearinghouse (http://www.mhselfhelp.org/) maintain listings of support groups on a broad range of mental health topics. The National Mental Health Consumers' Self-Help Group Clearinghouse also maintains a Directory of Consumer-Driven Services (http://www.cdsdirectory.org/) that includes peer-run organizations throughout the United States that offer a variety of supportive services and activities.   


In conclusion, these three health insurance topics - the future of the Affordable Care Act, rising premiums and out-of-pocket costs, and mental health coverage - are currently at the forefront of discussions in the US. As the landscape of health insurance continues to evolve, addressing these key issues will be vital in shaping the future of healthcare for all Americans. We will keep you updated as changes take place in health insurance, hopefully providing solutions to the top issues that affect so many individuals today.

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