What You Need to Know About ACA Open Enrollment 2017


Editor’s Note: Tony Steuer is the author of Insurance Made Easy and the Questions and Answers on Insurance Series. Tony is also an insurance consumer advocate and creator of The Insurance Bill of Rights. He’s been interviewed for many mainstream publications (Wall Street Journal, Forbes and The New York Times).

Open enrollment for individual health insurance policies opens on November 1 and remains open through December 15, 2017 (6 weeks). It is important to be aware of significant changes this year to successfully keep your health insurance and/or enroll.

Open enrollment is the only time when you are able to change to a completely new plan on the public marketplace or switch cover tiers with changes taking effect on January 1st. There are special enrollment periods for those who meet certain criteria such as losing group health insurance coverage.  Certain state exchanges have longer open enrollment periods including California, Colorado, District of Columbia, Massachusetts, Minnesota, Rhode Island and Washington (be sure to check the deadline of your state exchange).

The Affordable Care Act remains in place. Keep in mind that the ACA and Obamacare are the same thing.

The individual mandate means that there is a minimum penalty of $695 for adults and of $347.60 for children under age 18 for not having health insurance. The maximum tax penalty is $2,085 per household.

Shorter open enrollment period of 6 weeks rather than 12 weeks in previous years. Open enrollment starts on November 1, 2017 and ends on December 15, 2017 (6 weeks). It is important to act quickly and to be aware of this much earlier deadline.

What is the impact of the termination of the cost-sharing subsidies? 

Insurance companies must continue to offer policies with subsidized premiums to those who qualify (more than half of the 11.1 million Americans enrolled in ACA plans do!). The ACA requires insurers to charge lower out-of-pocket costs low-income consumers. CSR payments compensate insurance companies for doing so.

To find out how your state is allowing insurance companies to deal with the uncertainty over cost sharing reductions, check out this compilation of data.

Increased Tax Credits for those who qualify (84% of enrolled).

The ACA includes an additional subsidy that is designed to reduce the cost of premiums, ensuring that family budgets are largely unaffected called the Advance Premium Tax Credit. To qualify for the APTC, your income must be between 133% and 400% of the federal poverty level. Those who do not qualify for Advanced Premium Tax Credits will be most heavily impacted by premium increases. Find out if you qualify for the APTC here.

Increased premiums for those in Silver Plans in 2018.

Silver plans are the only plans that qualify for cost sharing reductions. Without the CSR’s, silver plans may no longer be the best choice for many people. Insurance companies will add a premium surcharge to the plans. Silver plans are the basis for the amount of the APTC that consumers receive. So, an increase in the silver premium will be offset by an increase in the APTC for most consumers. Because of the application of the CSR linked premium surcharge to silver-tier plans, nearly four out of five consumers will actually see their premiums remain the same or decrease as the amount of premium assistance they receive will rise. This may make bronze, gold and platinum plans more attractive.

Reduced access to healthcare.gov.

HHS has announced that it will shut down the federal exchange site for 12 hours for all but one Sunday during the open enrollment season (December 10th) as well as on the first day of open enrollment (November 1st). 36+ states use healthcare.gov for their marketplace.  This limited access could have a secondary impact of additional website outages with greater numbers of people using the site at one time compounded by the shorter enrollment period.

Less promotion.

Budgets have been restricted to mostly online outreach – so no television, radio or print ads. Don’t wait for any advertising for healthcare.gov .

Less help with open enrollment.

Budget cuts will mean fewer navigators, reducing the availability of advice to review different plans. More here: CMS Policies Related to the Navigator Program and Enrollment Education for the Upcoming Enrollment Period.

What to consider when reviewing your options:

  • If you are getting a subsidy, it is recommended that you review alternatives on gov or your state health insurance exchange.
  • Find out if you qualify for the APTC here.
  • Review the total costs: premiums, deductible and estimate co-payments and coinsurance.
  • Make sure that the plan covers your medical providers and medications.
  • Use the optimal insurance deductible calculator to find the deductible that provides the most value to you (click here).

Here are some resources to help you with open enrollment:

  • healthcare.gov – check it out now before open enrollment to review your options, so you can be prepared.
  • State insurance departments. Find a link your state insurance department here.
  • Private groups, consumer advocacy groups and insurance companies. For example, a new campaign “Get America Covered” is going to run digital advertising and will partner with employers, community organizations and other entities.
  • PolicyGenius has put together the comprehensive “Your state-by-state guide to the 2018 health insurance open enrollment period.”

If you have group health insurance through your employer, be aware of your open enrollment period and options.

It’s important to act early and be prepared. Understand what your health insurance options are and obtain coverage accordingly. To get the best plan at the optimal price, shop and compare the different tiers.

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Tony Steuer, CLU, LA, CPFFE

Tony Steuer is the author of Insurance Made Easy and the Questions and Answers on Insurance Series. Tony is also an insurance consumer advocate and creator of The Insurance Bill of Rights. He's been interviewed for many mainstream publications (Wall Street Journal, Forbes and the New York Times).