Many Americans are confused over the current climate of the Affordable Care Act. With open enrollment underway, some people believe the law no longer exists, while others believe premiums are on the rise and they can no longer afford monthly payments for health insurance. The Trump administration has made significant changes to how Obamacare gets implemented, which is aiding in the confusion and creating problems for those with health insurance, not to mention the people who still lack coverage. Today, we’re talking about the most pressing problems with open enrollment 2018 and how to deal with them.
Confusion about the Law
First off, the Affordable Care Act (ACA or Obamacare) is still the law. After many failed attempts by Congress to repeal the ACA this year, the law remains intact. Additionally, the Trump administration did not repeal the law. The president alone does not have the power to unilaterally repeal Obamacare no matter how many executive orders get signed. However, President Trump did sign several orders this year that made significant changes to the law.
It’s important to remember that under the ACA, Americans must have minimum essential health insurance for 2018 or face penalties from the IRS. Known as the individual mandate or Obamacare mandate, there is nothing in place as of now that removes the requirement. Therefore, Americans must have healthcare coverage for 2018 and should not ignore the mandate until the Trump administration issues something definitive about the requirement. Despite the president’s repeated statements that the ACA is dead, the law is still alive.
Limited Coverage Options
Every county in the U.S. will have at least one insurance company offering coverage through the individual marketplace. It’s true that many companies have left the Obamacare marketplaces in the last couple of years due to uncertainty surrounding the healthcare law. With some counties in the U.S. only having one insurance company, enrollees who need healthcare coverage for 2018 will have no choice but to enroll with that insurance company if they want an exchange-based plan.
There are options available off the marketplace, too, and you don’t have to sign up for major medical – although you will pay a fine if you don’t. For some, the penalty fee outweighs not buying health insurance. For others, ancillary products and short-term benefits may be a better choice even with the penalty fee. The takeaway is that you’ve got limited coverage options for 2018, but you do have options regardless of where you shop.
Cost-Sharing Reduction Payments
In early October, the Trump administration announced it would end cost-sharing reduction payments to insurance companies that help low-income Americans afford health insurance. Many of the insurance companies that participate in the individual marketplace braced for this announcement before it happened by raising the cost of monthly premiums. However, the move may have unintended consequences and could actually help some low-income Americans.
Although monthly premiums will rise significantly in 2018 due to the cuts, Americans who receive tax credits will be shielded from the price hikes. Some could end up paying less in premiums than what they paid in 2017. That might not make sense at first, but the math behind subsidy payments and tax credits is complicated.
Most of the premium increases for next year were tied to the silver plans offered on Obamacare exchanges. How much you get in tax credits is tied to the cost of the second-lowest priced silver plan in your area. Insurers priced silver plans to include a buffer in case Trump ended cost-sharing payments, which he did. Since premiums will rise in 2018 for a silver plan, the tax credits for low-income Americans will also rise.
With a larger premium tax credit, Americans who need coverage this year can use the bigger credit to buy a more generous gold plan, or they can choose to use the credit to buy a bronze plan for practically nothing (in some cases, literally nothing). The bronze and gold plans available on the individual marketplace did not change much since insurers loaded most of the premium increases onto the benchmark silver plans. Several affordable options or alternative plans exist for smart shoppers who look past the popular silver plans.
Lack of Help with Enrollment
This year’s enrollment season presents a number of challenges for a variety of reasons. The Trump administration isn’t solely responsible for all of the problems with the current healthcare law, but it isn’t helping. Making matters worse, Trump’s administration also cut the advertising budget for Obamacare by nearly 90 percent this year. This means fewer ad dollars will be spent explaining to Americans what they need to do during open enrollment. Additionally, the administration cut funding for programs offering in-person assistance, also known as “navigator programs,” by an average of around 41 percent.
However, some organizations and groups are still available to offer Americans who are confused about open enrollment in-person assistance. In fact, three states – Delaware, Kansas and West Virginia – have received the same level of funding for their navigator programs as they did last year. Groups in other states offering assistance are scrambling to use what few federal funds they have to offer help. If you’re struggling to navigate through this year’s enrollment period, schedule an appointment right away instead of waiting until the last few days of open enrollment.
You should also know that working with a licensed insurance agent or broker is still an option – and in some cases, a more valuable one than working with a navigator. Brokers are licensed to sell you insurance, and while that might seem too salesy, it can work in your favor since you don’t have to pay them directly (they’re paid by the insurance companies they represent). They can help you find a product that fits your specific needs and budget.
Navigators, on the other hand, can’t sell you anything because they typically aren’t licensed agents. They can help you enroll and navigate the HealthCare.gov website, but their services are limited to the Obamacare exchanges. Whether you choose an agent or a navigator, you’ve got resources at your disposable to cut through the clutter of enrollment this year.
Different Enrollment Deadlines
One of the biggest challenges to 2018 open enrollment is the significantly shorter signup period. The Trump administration cut enrollment in half for this year, lasting from November 1 through December 15 in most states. Last year, enrollees had until January 31 to sign up. Adding to the confusion is that some states have extended open enrollment. These are states with their own marketplaces apart from the federal site, and their deadlines vary as follows:
- California – January 31
- Connecticut – December 22
- Colorado – January 12
- District of Columbia – January 31
- Massachusetts – January 23
- Minnesota – January 14
- New York – January 31
- Rhode Island – December 31
- Washington – January 15
A special enrollment period has also been created for people who live in certain areas that were devastated by hurricanes earlier this fall. That extended enrollment period will run until December 31. Those who tend to put off signing up for health insurance won’t have as much time to dally this year. If you need health insurance for 2018, start shopping now to maximize your time.
HealthCare.gov Site Maintenance
Routine site maintenance is normal in any operation, and the same holds true for the federal exchange site at HealthCare.gov. But this year will see a marked increase in the number of times that the site will be unavailable to health insurance shoppers. According to several reports, the site will shut down for 12 hours every Sunday for maintenance except for the last Sunday of open enrollment. During previous open enrollment periods, site was only down for a few hours each week for site maintenance. Critics of the Trump administration believe that this is a deliberate attempt to sabotage enrollment.
The shutdowns will occur from 12:00 a.m. to 12:00 p.m. every Sunday during open enrollment, save the last one on December 10. According to officials from the Department of Health and Human Services, the shutdowns are necessary to compensate for the higher demand of a shorter enrollment period. To handle this issue, shop early and avoid the weekends if you can, when demand will undoubtedly be higher and the site may pose additional technical problems.
Not Shopping Around
The Trump administration’s decision to stop cost-sharing payments to insurance companies has inadvertently opened the door to better policies with lower premiums. In some cases, low-income Americans might qualify for an Obamacare health insurance plan with no monthly premium at all. However, consumers need to know that plans with little or no monthly premiums tend to have higher out-of-pocket maximums and deductibles. And on the flip side, higher-income Americans will bear the biggest burden of this year’s premium increases. One consistent problem facing open enrollment of any year is a lack of willingness to shop for better or different coverage than the plan people have in place.
This year, shopping is not only beneficial but in some cases necessary. Fewer options on the marketplace, the exit of major insurers in some states, higher premiums for unsubsidized plans and a host of other reasons making shopping for 2018 coverage even more critical. With all the uncertainty and confusion surrounding Obamacare this year, including a shortened enrollment period, it pays to shop around for plans – early, often and with help from a professional who knows how to navigate the process.