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2019 Healthcare Coverage: What Is New This Year

The healthcare space is always evolving and 2019 will be no exception. Here are some of the changes and trends patients can expect to see in the new year.

The Affordable Care Act (ACA) Tax Penalty is Going Away

One of the most newsworthy changes we’ll see in 2019 is the removal of the tax penalty for being uninsured. Currently, if you fail to enroll in minimum essential coverage and are not exempt, you could owe a tax penalty for the time you’ve been without health insurance. After January 1, 2019 that tax penalty goes away.

For some people, this could mean more health insurance coverage options for 2019. Depending on your healthcare needs and what you can afford, you could choose an ACA plan or you could choose to enroll in alternative coverage (e.g., a primary care membership or a medical cost-sharing program) instead.

Other experts predict that dropping this tax penalty could cause some healthy people to opt out of health insurance entirely. Without their premium payments, overall ACA costs may rise and the affordability of even the lowest-cost plans could be affected.

Health Insurance Premiums Are Predicted to Rise

According to a report from the Congressional Budget Office (CBO) , premiums for benchmark plans (the second-lowest-cost silver plan listed on ACA exchanges) are expected to rise by 15% in 2019 and then average a 7% increase each year thereafter, through 2028.

In addition to dropping the ACA tax penalty for uninsured individuals, other factors playing a role in rising 2019 healthcare premiums include the end of cost-sharing reductions (CSRs) and a lack of insurers willing to participate in the ACA exchanges.

Drug Cost Increases May Be Less Severe

It is an accepted reality that prescription drug prices rise each year. But in 2019, that increase may not be as steep as in previous years. The 2019 Segal Health Plan Cost Trend survey found that Rx drug cost increases are no longer in the double digits and are closer to medical cost trend rates for most prescriptions.

Specialty drugs, however, (e.g., biologics, medications injected or infused by an oncologist, etc.), which are a small share of total prescriptions but account for more than one-third of employers' pharmacy expenses, are still rising at double-digit rates.

These rising costs make free pharmacy discount cards an important way for consumers to manage what they spend on prescriptions. To get the best price on your medication, compare your insurance copay to discount Rx program rates online . You can also compare your copay amount to the pharmacy’s cash price .

Creative Employee Benefits Will Become More Commonplace

Employers know that the cost of providing benefits to their employees will continue to rise, so they are working with their benefits providers to creatively manage their offerings. Some of the more creative solutions in play include:

  • More virtual healthcare options for fast, inexpensive treatment of low-risk health issues like minor infections
  • A focus on preventative wellness programs, including increased use of wearable health trackers for employees
  • Robust online portals that make it easier for employees to understand and make the best use of their benefits


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