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The <keyword id="22902068" type="General" weightage="100" keywordseo="health-insurance-sector" source="keywords">health insurance sector</keyword> may face challenges in the coming months, due to <keyword id="20617555" type="General" weightage="20" keywordseo="rising-claims" source="keywords">rising claims</keyword> and increased competition, particularly in the retail sector, highlighted a report by <keyword id="19905137" type="General" weightage="20" keywordseo="Jefferies" source="keywords" meta.keywordsubtype="org" meta.entityname="Jefferies" meta.hostid="153" meta.entityid="Jefferies">Jefferies</keyword>. "Health (approx. 35% of mix) can see pressure in its retail segment from rising claims frequency and elevated competition" the report stated. The report indicated that <keyword id="19895063" type="General" weightage="20" keywordseo="India" source="keywords">India</keyword>'s <keyword id="22461357" type="General" weightage="20" keywordseo="non-life-insurance" source="keywords">non-life insurance</keyword> sector is experiencing significant shifts, the health insurance segment may face challenges as healthcare costs continue to rise and more consumers claim their insurance, and insurers are grappling with increased payouts. This trend could squeeze margins and put pressure on insurers to find ways to manage costs while remaining competitive in the market. However, for the <keyword id="20224622" type="General" weightage="20" keywordseo="motor-insurance" source="keywords">motor insurance</keyword> segment, the report draws a promising picture and added that it is entering a promising multi-year upcycle. This positive momentum is expected to benefit large private insurers of the motor segment, who are well-positioned to capitalize on these trends. "Initiate on Non-Life Insurers Large private insurers are set to gain from multi-year upcycle in motor (approx. 35% of premium mix) led by <keyword id="21232881" type="General" weightage="20" keywordseo="premiumization" source="keywords">premiumization</keyword> of underlying auto mix and moderating competitive intensity" the report mentioned. The report also added that the motor insurance segment in India is estimated to grow at a compound annual growth rate (CAGR) of 14% over the financial years 2024 to 2027. The key driver behind this growth is the ongoing shift in the automobile market towards higher-value vehicles. Over the past three years, the average selling price (ASP) of passenger vehicles (PVs) has increased by 41%, reflecting a move towards premium segments. This trend is expected to continue, benefiting motor insurance renewals, which account for 60-70% of the motor insurance premium mix. "Motor segment amidst a multi-year upcycle (est. 14% CAGR over FY24-27E) as renewals (60-70% of premium mix) will continue to benefit from the underlying change in auto mix towards premium high-value segments" the report added. Despite these challenges, the report mentioned that the broader non-life insurance market in India remains significantly underpenetrated, with insurance premiums representing only about 1% of the country's <keyword id="19904293" type="General" weightage="20" keywordseo="GDP" source="keywords">GDP</keyword>. This is relatively low compared to global peers, where non-life insurance to GDP ratios range between 2% and 4%. However, the Indian non-life insurance market has shown steady growth, with gross premiums expanding at a CAGR of 12% over the past five years, reaching Rs 2.8 trillion (approximately $35 billion). Notably, the private sector has outpaced the overall market. "India remains an under-penetrated market with non-life insurance to GDP at approx. 1% (vs 2-4% for global peers). Gross premiums have expanded at 12% CAGR over the last 5 years to Rs 2.8tn (approx. $35bn) with the private sector growing faster at 15% CAGR and improving its market share to 68%(from 57%)" said Jefferies in the report. Despite these challenges, the overall insurance market in India remains underpenetrated, offering significant long-term growth potential for insurers who can navigate these dynamics effectively.

Rising claims pose challenge for health insurance sector in India, says Jefferies

The <keyword id="19994390" type="General" weightage="100" keywordseo="GST-Council" source="keywords">GST Council</keyword> on Monday is expected to deliberate on a host of issues, including <keyword id="20118944" type="General" weightage="20" keywordseo="taxation" source="keywords">taxation</keyword> of insurance premiums, GoM's suggestions on rate rationalisation, and a status report on <keyword id="19939772" type="General" weightage="20" keywordseo="online-gaming" source="keywords">online gaming</keyword>, sources said. Sources said the fitment committee, comprising Centre and state tax officials, will present a report on GST levied on life, health and reinsurance premiums and the revenue implications. The GST Council, chaired by Finance Minister Nirmala Sitharaman and comprising state ministers, will decide on whether to reduce the tax burden on <keyword id="19894985" type="General" weightage="20" keywordseo="health-insurance" source="keywords">health insurance</keyword> from the current 18% or exempt certain categories of individuals, like senior citizens. The deliberations will also happen with regard to the goods and services tax (GST) cut on <keyword id="23083492" type="General" weightage="20" keywordseo="life-insurance-premium" source="keywords">life insurance premium</keyword>. In 2023-24, the Centre and states collected Rs 8,262.94 crore through GST on health <keyword id="22612491" type="General" weightage="20" keywordseo="insurance-premium" source="keywords">insurance premium</keyword>, while Rs 1,484.36 crore was collected on account of GST on health reinsurance premium. The issue of taxation on insurance premium figured in Parliament discussions with opposition members demanding that health and life insurance premiums be exempt from GST. Even Transport Minister Nitin Gadkari wrote to Sitharaman on the issue. Finance Minister Nirmala Sitharaman in her reply to discussion on the Finance Bill had said 75% of the GST collected goes to states and opposition members should ask their state finance ministers to bring the proposal at the GST Council. West Bengal Finance Minister Chandrima Bhattacharya had raised the issue in the meeting of the Group of Ministers (GoM) on rate rationalisation last month and the matter was referred to the fitment committee for further data analysis. The GoM had opined against any tinkering of four-tier GST slab of 5, 12, 18, and 28 % for the time being. The panel, however, had asked the fitment committee to look into any scope for rationalisation of rates of goods and services. With regard to online gaming, Centre and state tax officers will present a "status report" before the GST Council. The report would include <keyword id="20053837" type="General" weightage="20" keywordseo="GST-revenue" source="keywords">GST revenue</keyword> collection from the online gaming sector before and after October 1, 2023. From October 1, 2023, entry-level bets placed on online gaming platforms and casinos were subject to 28% GST. Prior to that, many online gaming companies were not paying 28% GST, arguing that there were differential tax rates for games of skill and games of chance. The GST Council in its meeting in August 2023 had clarified that online gaming platforms were required to pay 28% tax and subsequently, Central GST law was amended to make the taxation provision clear. Offshore gaming platforms were also mandated to register with GST authorities and pay taxes, failing which the government would block those sites. The council had then decided that the taxation on online gaming sector would be reviewed after six months of its implementation. Sources said the Council would deliberate on the status of taxation on the sector, and any change in tax rates is unlikely. Besides, the Council is likely to be apprised about the ongoing drive against fake registration, the success of the drive and action taken against such entities. The total amount of suspected GST evasion would also be presented before the Council. The drive, from August 16, 2024, to October 15, 2024, is aimed at detecting suspicious/fake GSTINs and to conduct requisite verification and further remedial action to weed out these fake billers. In the first drive between May 16, 2023 to July 15, 2023, against fake registration, 21,791 entities (11,392 pertaining to state tax jurisdiction and 10,399 pertaining to CBIC jurisdiction) having GST registration were discovered to be non-existent. An amount of Rs 24,010 crore (state - Rs 8,805 crore + centre - Rs 15,205 crore) of suspected tax evasion was detected during the special drive. Also, the Council would approve notifications, including that of the amnesty scheme, announced in the last council meeting. The council in June meeting took a host of taxpayer-friendly measures, including waiver of interest and penalty for demand notices issued in the first three years of GST -- 2017-18, 2018-19 and 2019-20 -- if the full tax demanded is paid by March 31, 2025. To reduce litigation, a monetary limit for tax officers, to file appeals before the GST Appellate Tribunal, the High Court and the Supreme Court was fixed at Rs 20 lakh, Rs 1 crore and Rs 2 crore, respectively, by the Council. It also recommended a reduction of the quantum of pre-deposit required to be paid by taxpayers for filing of appeals under goods and services tax (GST).

GST Council to deliberate on taxation of insurance premium, report on online gaming tomorrow

No expert committee has been set up for extending <keyword id="19923745" type="General" weightage="20" keywordseo="health-benefits" source="keywords">health benefits</keyword> to cover citizens aged 70 and above under <keyword id="19913233" type="General" weightage="100" keywordseo="Ayushman-Bharat" source="keywords">Ayushman Bharat</keyword>, <keyword id="22556022" type="General" weightage="20" keywordseo="Union-Minister-of-State-for-Health" source="keywords">Union Minister of State for Health</keyword> Prataprao Jadhav told the Lok Sabha on Friday. He was responding to a question on whether the government proposed to cover citizens aged 70 and above by expanding Ayushman Bharat through the launch of a <keyword id="21782708" type="General" weightage="20" keywordseo="National-Health-Claims-Exchange" source="keywords">national health claims exchange</keyword> and if an expert panel had been set up to strengthen the format of the scheme for the planned expansion. Jadhav, in a written reply, said all members of eligible families, irrespective of age, were covered under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana. The scheme provides <keyword id="19894985" type="General" weightage="20" keywordseo="health-insurance" source="keywords">health insurance</keyword> cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to 55 crore individuals, corresponding to 12.34 crore families, he said. "No expert committee has been set up for extending the health benefits to cover <keyword id="19894991" type="General" weightage="20" keywordseo="senior-citizens" source="keywords">senior citizens</keyword> aged 70 and above," he stated. Responding to another question, Jadhav said 34 insurers and third-party administrators were live and approximately 300 hospitals ramping up to start sending their claims on the National Health Claims Exchange (NHCX), which aims to streamline and fasten health <keyword id="35450" type="General" weightage="20" keywordseo="Insurance" source="Orion">insurance</keyword> claim processing, as on July 21. Jadhav said the government built the NHCX gateway under the Ayushman Bharat Digital Mission. It aims to streamline and standardise health insurance claim processing, enhance efficiency in the insurance industry and improve patient experience. It serves as a gateway for exchanging health claim information among insurers, third party audit, healthcare providers, beneficiaries and other relevant entities and ensures interoperability, machine-readability, auditability and verifiability, making the information exchange accurate and trustworthy, the minister said. This system will enhance efficiency and transparency in the insurance industry, benefiting policyholders and patients, he added. Supported by the Insurance Regulatory and Development Authority of India and the General Insurance Council, the NHCX will enable standardised and faster health insurance claim processing, Jadhav said.

No panel formed for extending benefits to cover citizens above 70 under Ayushman Bharat, says govt

<ul class="summary-list"><li>Lisa Jolly pays less for her health insurance thanks to enhanced premium tax credits.</li><li>These subsidies aim to reduce the price of health insurance purchased through the ACA marketplace.</li></ul>When Lisa Jolly enrolled in the <a target="_blank" class="" href="https://www.businessinsider.com/biden-expanding-obamacare-without-congress-health-coverage-2022-4">Affordable Care Act</a> marketplace, it was a lifeline, she said.Jolly, 55, was diagnosed with type 1 diabetes when she was 32 years old. Since then, she's had compounding health concerns, including neuropathy, stage 3 kidney disease, and anemia.For most of her life, Jolly was insured through her ex-husband's employment. But when they <a target="_blank" class="" href="https://www.businessinsider.com/divorced-boomers-lower-retirement-savings-401ks-social-security-income-2024-10">divorced</a> in 2021, she lost that coverage."I was probably near tears every day, wondering what in the world I was going to do," she said.Jolly enrolled in the ACA marketplace the following year and qualified for enhanced premium tax credits, which aim to reduce the price of health insurance purchased through the ACA marketplace. She pays $96 monthly for healthcare coverage, according to documents reviewed by Business Insider."I just remember being extremely grateful and almost astounded that there was something out there that was going to help me be able to afford health insurance," she said.Jolly is among the millions of Americans who use the enhanced premium tax credits to afford healthcare coverage and who could see costs rise next year if the subsidies expire.According to the Center on Budget and Policy Priorities, <a target="_blank" class="" href="https://www.businessinsider.com/millions-americans-lose-health-insurance-subsidies-congress-presidential-election-2024-9">19.7 million ACA enrollees</a> qualified for enhanced premium tax credits this year, which is 92% of all ACA enrollees. Additionally, the enhanced premium tax credits cut consumers' costs by about 44%, saving the average enrollee $705 annually, according to a <a target="_blank" class="" href="https://www.kff.org/affordable-care-act/issue-brief/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/">report</a> published on July 26 by KFF, a nonprofit health policy group.The subsidies were introduced in 2021 as a temporary measure and expanded eligibility to include enrollees with incomes above 400% of the federal poverty line — which is $60,240 for one individual and $124,800 for a family of four. In 2022, the Inflation Reduction Act extended the subsidies through the end of 2025.According to a Center on Budget and Policy Priorities analysis shared with Business Insider, without the enhanced premium tax credits, Jolly's monthly payments could increase to $275, a roughly 186% jump."It would just have an enormous negative impact on my life," Jolly said.<h2 id="4569c228-efc2-46ce-bac2-07c53459536a">Subsidies helped Jolly afford healthcare coverage</h2>Jolly lives in Steubenville, Ohio — a city about 30 miles west of Pittsburgh — with her 24-year-old daughter, Jessica. Jolly bought a small house in September 2023, using the funds she received from her divorce settlement.Jolly receives a monthly spousal settlement payment, which is her only income. Due to her health complications, Jolly said she is unable to retain a full-time job. She said she is trying to land a part time job as a teaching assistant, but her health issues mean she is often faint and unable to concentrate for extended hours.Jolly said she isn't eligible for many social safety nets. Additionally, she said she's burned through her savings."I'm struggling," Jolly said. "When I combine rising grocery costs with rising insurance costs, it just becomes almost unbearable."<h2 id="ec005901-4bba-4522-bd8a-c2e31c9f82d3">The subsidies expiration could pose difficulties for millions of Americans</h2>The results of the November election could determine the fate of the enhanced subsidies. On September 25, Democratic Senators Jeanne Shaheen and Tammy Baldwin introduced the Health Care Affordability Act, which would make permanent enhanced premium tax credits. Rep. Lauren Underwood, another Democrat, introduced an identical bill in the House.The bills would have to pass both the Senate and the House and then be signed into law by the president to come into effect. It's <a target="_blank" rel=" nofollow" class="" href="https://www.washingtonpost.com/health/2024/09/25/aca-health-plan-subsidies/">unclear when a decision</a> on the tax credits will be reached.Republican lawmakers oppose the subsidies' cost to taxpayers. The Congressional Budget Office and Joint Committee on Taxation <a target="_blank" href="https://www.cbo.gov/system/files/2024-06/60437-Arrington-Smith-Letter.pdf">estimate</a> that making the policy permanent would increase the budget deficit by $335 billion over the next 10 years.Cynthia Cox, a vice president at KFF, previously <a target="_blank" class="" href="https://www.businessinsider.com/millions-americans-lose-health-insurance-subsidies-congress-presidential-election-2024-9">told</a> Business Insider that Congress might end up with a divided House and Senate after the election, making it difficult to pass a bill."There's a pretty significant chance that there's going to be a divided power in Washington, and then it's really anyone's guess what happens to these subsidies, but it would probably be an uphill battle to renew them," Cox said.The Congressional Budget Office estimates that 3.8 million people could become uninsured if the enhanced subsidies expire, according to <a target="_blank" href="https://www.reuters.com/business/finance/rate-us-uninsured-rise-89-next-decade-congressional-budget-office-says-2024-06-18/#:~:text=Enhanced%20subsidies%20for%20plans%20introduced,the%20expiration%20of%20marketplace%20subsidies.">Reuters</a>.For enrollees like Jolly, the hundreds of dollars saved each month have been crucial to affording coverage."If we didn't have them, I don't know how I would have survived day-to-day," Jolly said. "It just would have meant total ruin for myself, and I'm not even talking economically, but I mean health-wise, too."

Subsidies help a 55-year-old pay $96 a month for health insurance. Her costs could increase 186% if they expire next year.

<ul class="summary-list"><li>Shanna Nasiri, 34, decided to leave her tech job when she no longer felt aligned with the work.</li><li>Earlier this year, she opened a natural wine bar in Williamsburg called With Others.</li></ul>This as-told-to essay is based on a conversation with Shanna Nasiri, the 34-year-old owner of <a target="_blank" class="" href="https://www.withothersbrooklyn.com/?fbclid=PAZXh0bgNhZW0CMTEAAaYikrw0VpjpCpAQ0ZvjvLvpFSaoADEXEYZSPsfVYegg3r5FJj2KHjPZ-Cs_aem_1Utqp3zKNtwMvha7MZMTkA">With Others</a>, a natural wine bar in Brooklyn, New York. It has been edited for length and clarity. Business Insider has verified Nasiri's salary.I grew up in the <a target="_blank" class="" href="https://www.businessinsider.com/moved-san-francisco-worth-it-cost-of-living-negativity-2024-2">Bay Area</a> near Silicon Valley, and everyone I knew was in some variation of tech. I continued on that trajectory.My first job was working for the corporate ventures team at Qualcomm. After that, I worked in semiconductors for a few years. Then, I went back to business school and got a job in product marketing for a regulatory technology startup.I liked aspects of what I was doing. The <a target="_blank" class="" href="https://www.businessinsider.com/big-tech-workers-pushed-limits-of-perks-benefits-pampering-over-2024-10">perks</a> were nice. I had full benefits. And there <a target="_blank" class="" href="https://www.businessinsider.com/left-big-tech-job-uber-entrepreneur-2024-10">was the salary</a>. I was making around $200,000 at the time I left, plus a bonus. I also got a lot of stock options.I was working for <a target="_blank" class="" href="https://www.businessinsider.com/startups-to-bet-your-career-on-in-2024-2024-2">startup companies</a>, so I had the chance to be at the ground level, build teams, and craft messaging. I felt like I had an impact.But I wasn't creatively fulfilled. I didn't like what I was doing. It didn't resonate with who I am. I was kind of embarrassed to tell people I did product marketing for regulatory technology startups. I felt like I was speaking a different language.At the time, I compartmentalized. This is who I am at work, and this is who I am in my personal life. I just accepted my life for what it was and figured you could <a target="_blank" class="" href="https://www.businessinsider.com/happiness-at-work-employee-engagement-fulfillment-flexibility-four-days-2023-12">never be fully happy at work.</a><h2 id="ddbf58b0-8e32-403f-9d1f-46fdacdaa027">That started to change when I turned 30</h2>Around my 30th birthday, I started having these existential questions and ideas. I had recently moved from San Francisco to New York City. That was also right at the start of COVID, so I had a lot of <a target="_blank" class="" href="https://www.businessinsider.com/how-the-pandemic-changed-my-career-2-years-stories-2022-3">alone time to reflect.</a>I was seeing this whole new world in <a target="_blank" class="" href="https://www.businessinsider.com/san-francisco-new-york-london-tech-where-to-live-2024-8">New York City</a>, with so many diverse careers. In San Francisco, I knew a lot of tech founders. But when I moved to New York, I started to see that entrepreneurship could have a greater meaning beyond tech.<div type="image" title="A photo of Shanna Nasiri holding a bottle of wine next to a photo of Williamsburg" height="1500" width="3000" msid="115114938" hostid="261" sizebytes="438074"></div>I had always fantasized about opening a space, but it wasn't something I thought I would actually do.I moved to <a target="_blank" class="" href="https://www.businessinsider.com/photos-show-what-its-like-to-live-in-williamsburg-brooklyn-2021-5">Williamsburg in 2021</a>. It was still pretty desolate at the time. There were lots of empty storefronts. I would go on these long walks and start fantasizing about what I would do with the space.I've always been passionate about hosting. I love to curate an environment. I'm obsessed with the little details like glassware, music, lighting, and sparkling water choice. I grew up in a family where my mom and grandma would host huge parties all the time and I was the mini host. I'm Middle Eastern and I think there is a sense of Middle Eastern hospitality that's embedded within me.My <a target="_blank" class="" href="https://www.businessinsider.com/guides/kitchen/types-of-wine">wine journey</a> started young. My stepdad collected limited-production Pinot Noirs. He introduced me to wine and taught me how to taste and the artisanship that goes into production.When I think about it now, it was pretty brazen to start a wine bar. But it was COVID, and <a target="_blank" class="" href="https://www.businessinsider.com/how-people-changed-careers-jobs-during-pandemic-2022-3">life felt so short and precious</a>. I wanted to prove to myself I could do itIt was either get stuck in this unfulfilling career trajectory and <a target="_blank" class="" href="https://www.businessinsider.com/careerist-corporate-ladder-decline-promotions-work-ethic-american-dream-2024-10">climb the corporate ladder</a>, or try to be an entrepreneur. It was a huge leap of faith and required me to believe in myself 100%So, in the summer of 2022, I got a job at a wine bar in Brooklyn to see what it was like. I was so passionate about it.After that, I started pursuing my wine education and got my Wine and Spirit Education Trust certification, which is a globally recognized qualification. I got a job at a wine shop. And I fully committed to opening my own bar.<h2 id="49faa484-70c2-47b4-9558-670c2708ed17">My tech experience came in handy</h2>A lot of my past work was helpful as I was building the bar. I knew how to manage teams. I had always worked at the ground level, so I had experience juggling a lot of responsibilities and working with limited resources.I started asking everyone to introduce me to other entrepreneurs and asking about their contractors, their agents, and their plumbers.<div type="image" title="A photo of Shanna Nasiri posing at her wine bar next to a photo of Williamsburg" height="1500" width="3000" msid="115114935" hostid="261" sizebytes="153358"></div>I used my own money and opened the bar on a very small budget.It took me a year to find the space because I was only looking for places within a few blocks of my home. I wanted it to be really integrated with the community. I found the space in June 2023 and started construction in October 2023.We opened in March of this year. It's been incredible. It's beyond anything I could have ever imagined.It has quickly become the neighborhood spot. We have regulars that come in twice a week. And the coolest thing has started happening recently, where I have probably met 11 or 12 parents of our regulars.I've continually reinvested in the bar. For example, the backyard buildout happened three months after we opened. After that, I built out the basement and cellar. Then I invested in hiring a general manager and growing out the wine list.<h2 id="ac1863d1-953a-4300-b4ce-24a04c6e730e">It's been a major lifestyle change from tech</h2>I don't have health insurance. I'm working probably 12-hour days. There's just so much stuff to do in terms of maintenance. And I work service every single night.In tech, I could work from anywhere. I traveled a lot and <a target="_blank" class="" href="https://www.businessinsider.com/working-remotely-feel-isolated-from-coworkers-quit-2024-7">worked remotely</a>. Now, I have a physical space. I haven't left a 20-mile radius since Christmas and have no plans to.But I feel so aligned with what I'm doing. It feels like what I was always meant to be doing. I work way more hours than I did in tech, but it doesn't feel as hard.I'm in such awe of what we've been able to create in such a short amount of time.

I left my $195,000 tech job to open a wine bar. I work 12-hour days and don't have health insurance, but I've never been happier.

<ul class="summary-list"><li>Trump said he plans to change the Affordable Care Act, which provides healthcare for 45 million Americans.</li><li>His past actions include ACA opposition. He has flip-flopped on Medicaid and Medicare cuts.</li></ul>Donald Trump's return to the Oval Office could mean changes to Americans' healthcare coverage, based on his previous comments and actions while president.During his recent campaign, Trump promised to <a target="_blank" class="" href="https://www.businessinsider.com/what-us-economy-would-look-like-with-trump-biden-presidency-2024-5">make changes to the Affordable Care Act</a>, colloquially called Obamacare, but did not give specifics."If we can come up with a plan that's going to cost our people, our population less money and be better healthcare than Obamacare, then I would absolutely do it," Trump said at the presidential debate in September.As president, he will also have the power to influence America's healthcare landscape, including insurance coverage, drug price negotiations, government <a target="_blank" class="" href="https://www.businessinsider.com/fluoride-in-water-why-it-is-controversial-risks-benefits-2024-11">health and safety regulations</a>, and reproductive healthcare access.Trump has a <a target="_blank" class="" href="https://www.businessinsider.com/healthcare-investors-torn-on-trump-second-term-2024-11">mixed record</a> on supporting government health insurance policies like the ACA, which the Department of Health and Human Services estimated covers 45 million people in health plans like <a target="_blank" class="" href="https://www.businessinsider.com/medicare-changes-increase-costs-deductibles-prescription-drugs-premiums-copays-2024-10">Medicare</a> and Medicaid. Also in the hot seat: the enhanced federal ACA subsidies, which are <a target="_blank" class="" href="https://www.cbsnews.com/news/trump-aca-subsidies-health-insurance-affordable-care-act-congress/">set to expire</a> at the end of next year.If Trump doesn't extend the enhanced subsidies policy, which helps many low- and middle-income Americans pay for medical care, the Congressional Budget Office estimated that <a target="_blank" href="https://www.cbo.gov/system/files/2024-07/60523-2024-07-premium-tax-credit.pdf">nearly 4 million people </a>will lose their coverage in 2026 because they won't be able to afford it.Trump's transition team told Business Insider in a statement that he will "strongly protect" Medicare in his second term — although he has <a target="_blank" class="" href="https://www.businessinsider.com/trump-cutting-medicare-social-security-benefits-2024-3">previously suggested cuts</a>. Any changes to Medicaid and Medicare under Trump could also cause those with ACA insurance see a reduction in their care options.<h2 id="69e6831b-4c89-4dd9-8ec0-501ab8666185">Medicare, Medicaid, and preexisting conditions</h2>Trump has not provided specifics about his affordable healthcare policies, beyond saying he has "concepts of a plan" at the September debate.During his first term, Trump backed a rejected Supreme Court case to overturn the Affordable Care Act, which former President Barack Obama passed in 2010 and that expanded Medicaid coverage for low-income Americans and Medicare coverage for older Americans. ACA's other marquee change required insurance companies to cover care for individuals with preexisting conditions, like asthma, heart disease, and diabetes.Yunan Ji is an assistant professor and economist at Georgetown University with an expertise in healthcare policy. She told BI that reducing or repealing ACA coverage — which Trump proposed during his first-term — could be detrimental to Americans with preexisting conditions, who may lose their coverage or have to pay more for healthcare."We purchase insurance to protect against future risk," Ji said. "If we make people go into a different risk pool when they require care for some medical condition, that defeats the purpose of insurance."Trump has also voiced support for privatizing more of the healthcare sector. This could mean some Americans on ACA plans could face higher out-of-pocket costs and fewer in-network care options.President Joe Biden's <a target="_blank" class="" href="https://www.businessinsider.com/house-passes-inflation-reduction-act-sending-it-to-biden-2022-8">Inflation Reduction Act</a> also took steps to lower the cost of prescription drugs and cap out-of-pocket costs for Medicare beneficiaries. The legislation <a target="_blank" href="https://www.axios.com/2024/02/07/trump-medicare-price-negotiations-executive-power">requires</a> Trump to continue existing drug price negotiations through at least the end of 2025.<h2 id="1380ef19-42c4-43c1-841e-04dcb5227dd9">Reproductive and gender-affirming care</h2>Trump has said he would take steps to <a target="_blank" href="https://www.nbcnews.com/politics/2024-election/trump-vows-stop-gender-affirming-care-minors-re-elected-president-rcna68461">ban all gender-affirming healthcare and hormone therapies</a> for minors, which ACA plans cover in some states.<a target="_blank" href="https://www.businessinsider.com/what-is-project-2025-conservative-political-playbook-heritage-foundation-trump-2024-7">Project 2025</a>, a policy plan proposed by Trump allies, calls for significant national restrictions on abortion and birth control. Trump has expressed support for federal enforcement of the Hyde Amendment, a rule that prevents Medicaid from covering abortion pills and procedures. Among the <a target="_blank" class="" href="https://www.kff.org/womens-health-policy/dashboard/abortion-in-the-u-s-dashboard/">37 states and DC</a> that do not ban abortion, <a target="_blank" href="https://www.kff.org/medicaid/state-indicator/abortion-under-medicaid/?currentTimeframe=0&amp;sortModel=%7B%22colId%22:%22Follows%20Federal%20Standard,%20Funding%20Only%20Cases%20Involving%20Life%20Endangerment,%20Rape%20and%20Incest%22,%22sort%22:%22desc%22%7D">17 states and DC</a> currently follow the Hyde Amendment.Trump has called for federally-subsidized in-vitro fertilization — a proposal that is divisive among Republicans.<h2 id="f6dc24d6-1b01-41c0-99ba-9603db98ef3f">Insurance regulations and national health policy</h2>Ji said that Americans often focus on the sticker price of premiums in their healthcare plan — how much they are expected to pay out-of-pocket each month or year. But a Trump presidency would also shape rules and regulations for insurance companies. For example, companies are required to cover a wide range of providers, so someone with heart disease can find an in-network cardiologist in their area.Ji added that Trump's cabinet appointments will give insight into his second-term healthcare priorities. His leadership selections will determine federal investment in medical research, health and safety guidelines, insurance company regulations, and vaccines. Trump is expected to <a target="_blank" href="https://www.nbcnews.com/politics/2024-election/trump-banning-vaccines-president-rfk-fluoride-rcna178570">discourage vaccinations</a> and limit federal health and insurance regulations.Trump tapped <a target="_blank" class="" href="https://www.businessinsider.com/trump-robert-f-kennedy-jr-rfk-department-health-human-services-2024-11">Robert F. Kennedy Jr.</a> on November 14 to lead the Department of Health and Human Services, a decision that will require Senate approval. Kennedy has not outlined specific plans to increase healthcare affordability, but he would have some influence over the ACA in the role. The former presidential candidate is a vaccine-skeptic, who Trump hopes will "<a target="_blank" class="" href="https://www.businessinsider.com/how-rfk-jr-plans-to-make-america-healthy-again-2024-11">go wild</a>" on health, safety, and food protocols.Any major changes to healthcare policy and federal budgets would need to be approved by Congress. Trump will likely have the support of a Republican-led Senate and House."The American people re-elected President Trump by a resounding margin giving him a mandate to implement the promises he made on the campaign trail," Karoline Leavitt, a spokesperson for the Trump-Vance transition team, told BI in a statement. "He will deliver."Are you doing anything to prepare your finances or healthcare plan for Trump's second term? If so, please reach out to this reporter at <a target="_blank" class="" href="mailto:allisonkelly@businessinsider.com">allisonkelly@businessinsider.com</a>.

Trump's plans to change healthcare could slash insurance for some low-income Americans and retirees

<ul class="summary-list"><li>Many companies don't have cyber insurance because of costs, but the market is growing.</li><li>Cyber insurance can help companies recover financially from cyberattacks and data breaches.</li></ul><a target="_blank" href="https://www.businessinsider.com/guides/tech/what-is-a-cyber-attack">Cyberattacks happen every day</a>, and any company that relies on technology to conduct business is at risk. But one way leaders can minimize the impact of <a target="_blank" class="" href="https://www.businessinsider.com/how-companies-can-respond-to-cybersecurity-risks-after-layoffs-2024-9">losses from a cybersecurity incident</a> is by getting cyber insurance."All companies can benefit from having cyber insurance," said Shruti Engstrom, the senior vice president of errors and omissions/cyber at the risk-mitigation company Aon. "This is a risk that's here to stay."Cyber insurance helps organizations recover the costs of a cybersecurity incident, the global average of which IBM estimates is about <a target="_blank" href="https://www.ibm.com/reports/data-breach">$4.9 million</a>. Engstrom told Business Insider that these expenses might include shutting down production lines, computer systems, or other operations, as well as the fallout of customer information being released."If something bad happens — there's a data breach or ransomware attack — and it costs you a lot of money, you have coverage to help with that," <a target="_blank" href="https://fletcher.tufts.edu/people/faculty/josephine-wolff">Josephine Wolff</a>, an associate professor of cybersecurity policy at Tufts University, said.The cyber-insurance <a target="_blank" href="https://content.naic.org/sites/default/files/inline-files/Final%202023%20Cyber%20Report.pdf">market is growing</a>, Wolff said, but many companies still lack coverage. Here's what business leaders should know about cyber insurance.<h2 id="e78eaf2c-45e6-4e54-9e2e-14bdcdc2b1ad">The benefits of cyber insurance</h2>Cyber insurance can minimize the financial blow of a cyberattack, but it's not just about the money, said <a target="_blank" href="https://www.bitsight.com/about/our-team/stephen-boyer">Stephen Boyer</a>, a cofounder and the chief innovation officer at Bitsight, a cyber-risk-management company. Insurance also gives companies access to incident-response expertise, such as cybersecurity tools, legal assistance, and ransomware negotiation."If a company experiences a cybersecurity incident and has insurance, it can tap into a world of expertise that it may not otherwise know existed," Engstrom said.Cyber insurance is available as a stand-alone policy or incorporated into other business coverage. When a company purchases the insurance, it undergoes an application and <a target="_blank" href="https://www.usatoday.com/money/blueprint/insurance/what-is-insurance-underwriting/">underwriting process</a>, which helps leaders assess the health of their cybersecurity measures and ability to protect their firm from bad actors, Engstrom said.A better understanding of a company's risk is an important benefit of cyber insurance, Boyer said. But not enough companies, especially smaller ones, are getting the insurance, he added.One reason is the cost: The <a target="_blank" href="https://cyberreadinessinstitute.org/resources/cyber-insurance-faqs-for-small-and-medium-business/">Cyber Readiness Institute</a> estimates that cyber insurance can cost businesses $500 to $5,000 a year. But cyberattacks can be much more costly to an organization's bottom line and its reputation, Boyer said.<h2 id="c6454cb6-2ed4-4a3e-8923-2f759517c2ba">What cyber insurance does and doesn't cover</h2>Many policies offer first- and third-party coverage, and most companies need both, Engstrom said.While all policies are different, first-party insurance typically covers losses incurred because of a cyberattack. According to the <a target="_blank" href="https://www.ftc.gov/business-guidance/small-businesses/cybersecurity/cyber-insurance">Federal Trade Commission</a>, it can also cover costs such as legal counsel, forensic-investigation services, recovery of stolen data, communication with customers, fees and penalties to regulatory bodies, crisis management, public relations, and lost income.Some policies also cover ransomware negotiation and payments to hackers. However, Wolff said this is a controversial aspect of cyber insurance, as many believe it incentivizes criminals to continue launching attacks.Engstrom said third-party insurance covers legal fees and settlement costs when a customer, a vendor, or another third party seeks legal damages as a result of a cybersecurity incident."Companies that are at risk of a cybersecurity incident are almost always at risk of a related third-party conflict," she added.Boyer told BI that cyber insurance usually doesn't cover losses related to intellectual property or preexisting cybersecurity incidents. Acts of war or attacks related to terrorism, which typically affect high-level companies and organizations, are also not covered, Wolff said.Additionally, according to <a target="_blank" href="https://www.ibm.com/topics/cyber-insurance">IBM</a>, attacks caused by network failures, negligent or malicious employees, or social engineering, such as phishing scams, might not be covered.Engstrom said the policies also typically don't cover the cost of hiring more security or IT staff or upgrading cybersecurity systems to prevent attacks."Many don't realize that these long-term structural and preventative improvements are not covered under most cybersecurity-insurance policies," she added.<h2 id="3ec2bff8-ffa8-4c28-9e6a-8cdb3b73a14a">What to look for in a cyber-insurance policy</h2>Policies differ depending on the insurer, Wolff said, and companies can sometimes negotiate their coverage. So it's crucial to ask a lot of questions before signing on."One really important thing to go through with your carrier is the specific exclusions in your policy," she added. "The more you can get into the specifics of that, the less likely you are to be taken by surprise when you're trying to file a claim."Basically, make sure the policy adequately covers your level of risk, Engstrom said.Wolff suggested discussing how pricing is determined and which cybersecurity measures insurers require companies to have — some might offer lower pricing for companies with upgraded cybersecurity infrastructure.Some insurance companies also offer training or support to educate an organization's staff on cybersecurity best practices, Engstrom added.She said to also find out about the claims process: "If a company experiences a cybersecurity incident, they must understand how their insurer steps in and what kind of support is provided. Leaders need to know that their insurance company is there for them every step of the way."Ultimately, companies should understand their cyber risks and know what protection they need when purchasing insurance, Boyer said."What are you trying to protect, and what's the risk transfer?" he said. "It obviously depends on your business — some businesses are just more exposed to this sort of risk and could really have some sort of payout."

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