Health care news to watch for in 2016

The Supreme Court’s ruling in King v. Burwell was arguably the most important health care news in 2015. Upholding the government’s ability to give subsidies to individuals who bought insurance on the federal exchange, the ruling saved millions of people from higher health insurance costs while frustrating those who felt the ruling took power away from the states. Many experts had predicted that a different ruling could have caused an unraveling of health care reform.

While King v. Burwell made 2015 exciting, 2016 is shaping up to be a pretty exciting year for health care as well. The following are the top three news items to watch for in the new year.

1. Penalties for not having coverage skyrocket. Under health care reform, individuals are required to have a minimum level of health insurance coverage as defined by the government. If you do not have that minimum level of coverage, you’re required to pay a penalty at tax time.

This has been the case for a few years now. The last big increase for this penalty, however, is scheduled for this year. Going forward, it is scheduled to simply be indexed to inflation.

So how big is that big increase? The penalty is calculated two ways, and you have to pay the higher of the two. The first method is based on household income. Last year the penalty was 2 percent of income and this year it is 2 1/2 percent of income. The second is per person in your household. This year it is $695 per adult and $347.50 per child, up from $325 per adult and $162.50 per child last year.

These penalties are designed in part to encourage people to sign up for health insurance. After all, those who can least afford to pay these penalties are also those who are eligible for the biggest subsidies. Expect some headlines around tax time about individuals who are surprised by how big the penalties are, and cannot sign up for coverage until 2016’s open enrollment.

2. UnitedHealthcare stays — or leaves — the exchanges. UnitedHealthcare made headlines recently when it said it was scaling back efforts to gain customers in the health insurance exchanges for 2016 — and that it may completely withdraw from them in 2017. It cited higher risks and more difficulties creating profitable products for the exchanges.

In 2015, many of the health insurance co-ops created by health care reform, including Tennessee’s own Community Health Alliance, proved unable to stay in business and on the exchanges. If a major carrier like UnitedHealthcare decides to leave, it could signal bad things for the future. As a result, expect headlines about what UnitedHealthcare ultimately decides to do.

3. November’s election. Republicans running for president have promised, in one way or another, to repeal “Obamacare.” Therefore, if one of the Republican candidates wins, expect a lot of headlines with speculation as to what that will look like. Many have talked about ideas such as allowing insurance companies to compete with each other across state borders. Expanded adoption of Health Savings Accounts is another popular idea. Leading candidate Donald Trump has promised he will replace Obamacare with “something terrific.”

If a Democrat wins, expect fewer headlines about replacing health care reform and more about tweaking it. Few, even on the Democratic side, would argue that the law is perfect as it is written today. At the least we can expect some adjustments as the more punitive parts of the law take hold over the next few years. Recently, for example, the Cadillac tax on high-priced health plans was pushed back to start in 2020 instead of 2018.

The bottom line is that next year promises to be another interesting one for health care consumers everywhere.

Alex Tolbert is the founder ofBernard Health, a company that provides non-commissioned, expert advice on health, Medicare and COBRA insurance and medical bill consulting.