If you’re self-employed and freaking out about your health insurance coverage, raise your hand. With a commander-in-chief who appears determined to dismantle the health insurance marketplace established under Obamacare — and seemingly millions of fellow Americans cheering him on — these are scary times for those with individual health insurance plans.
While the majority of people get health insurance through their workplace or a government program such as Medicaid or Medicare, a percentage of the population has to buy their own coverage. According to the Kaiser Family Foundation, 7 percent of Americans were covered by nongroup plans in 2016. Many of these are the Obamacare plans sold on the federal government’s health insurance marketplace or in state insurance marketplaces.
The 2017 open enrollment period begins today for marketplace policies, and we’ve got good news and bad news for you. The good news is that critics in Washington of Obamacare (officially called the Affordable Care Act) haven’t succeeded in cutting off your access to health insurance coverage yet. The bad news is just about everything else we’re about to tell you.
Here are seven things to know about the 2017 open enrollment period for Obamacare plans on the health insurance marketplace.
1. The enrollment period is shorter … much shorter
In previous years, you had three full months to select a plan off the health insurance marketplace. If you woke up on Jan. 31 and realized you hadn’t enrolled yet, you still had until midnight that day to do so.
This time around, you’ll only have from Nov. 1 to Dec. 15 to buy health insurance on the marketplace. After that, you’re out of luck unless you qualify for a special enrollment period.
2. Don’t expect government reminders
Ask anyone registered at HealthCare.gov, the health insurance marketplace website, and they’ll tell you that previous years have brought an onslaught of emails. These missives helpfully told them things like: Open enrollment is about to begin; open enrollment is underway; open enrollment is almost over; and — in case you missed it — open enrollment is happening NOW.
Don’t expect such attention from the federal government this year. The Trump administration has slashed funding for HealthCare.gov promotion by 90 percent, a move the former CEO of the site says he believes is designed to suppress enrollment. (Why would the government want to suppress enrollment? Because the fewer people who are using the marketplace, the easier it is to justify its demise.)
3. There will be fewer resources to help you enroll
It isn’t only HealthCare.gov promotion funding that has been cut. The Affordable Care Act Navigator program has seen its funding slashed as well. The Navigator program is what has been providing grant money to local nonprofits who help people select the right plan and enroll through the marketplace.
Funding reductions vary by organization and depend on how well a group met previous enrollment goals. For instance, the budget for groups that act as navigators in Ohio has been cut by 71 percent, while groups in Michigan are facing budget cuts of up to 90 percent. In announcing the funding change, the Centers for Medicare & Medicaid Services said adjustments to the Navigator funding formula are intended to ensure accountability.
4. Federal assistance is shifting
Plans are sold on the Obamacare marketplace in four categories: bronze, silver, gold and platinum. If you have a silver plan and qualify financially, you can receive cost-sharing assistance to reduce the amount of money you pay in health insurance premiums. In previous years, the federal government has helped support these subsidies by making payments to insurers.
However, President Donald Trump recently signed an executive order eliminating those payments to insurance companies.
This does not mean you will not receive subsidies in 2018. By law, insurers still have to provide cost-sharing reductions to silver plan participants who have household incomes at or below 250 percent of the poverty level.
The bad news is many insurance companies anticipated the loss of government cost-sharing reduction payments and padded their premiums as a result. The Kaiser Family Foundation estimates silver plan premiums are going up anywhere from 7 to 38 percent because of the lost government funds. The good news is that if you receive a premium subsidy, your subsidy amount should increase to cover that amount.
For more on this change, check out: “Trump Ends Subsidies for Health Insurers: How It Impacts You.”
5. Your premium is most likely going up
Health care consulting firm Avalere Health analyzed available data and found silver plan premiums for a 50-year-old will increase by an average of 34 percent in 2018. The group attributed this increase to the following factors:
• Loss of cost-sharing reduction payments
• Enrollment numbers lower than anticipated
• Limited number of insurers in the marketplace
• Insufficient government action to reimburse plans covering higher-cost enrollees
• General volatility and uncertainty about the future of exchanges and the policies governing them
Actual premium increases will vary by state. Avalere found Iowa residents will experience the biggest sticker shock, with their premiums jumping an average of 69 percent. Those folks may want to consider moving to Alaska, where the average cost of a silver plan for 2018 is expected to drop 22 percent.
6. New off-market plans may be available
As long as the federal government continues to offer premium subsidies, buying on the health insurance marketplace may continue to be the best deal for many families. However, for those who earn more than 400 percent of the federal poverty limit — the cutoff for subsidies — the increasing premiums may put coverage out of reach. (Get an idea of how your household stacks up against the federal poverty limit at this site.)
For those who want to go off-market, some insurers are debuting new plans intended to provide pricing relief. These plans may have narrow provider networks or other provisions that differ from on-market plans so shop carefully. Make sure whatever you choose will meet the standards of qualified health coverage to avoid a tax penalty.
Need another way to take the sting out of health care costs? Read this post about health savings accounts and other tax-friendly ways to cover medical and retirement expenses.
7. You’ll pay a price if you skip enrollment – and coverage – for next year
Speaking of that tax penalty, some people thought that, under President Trump, the IRS would stop enforcing the Obamacare health insurance mandate. However, that is not true. The IRS will reject tax returns filed electronically next year unless they indicate whether a person has health coverage, is eligible for an exemption from the mandate or is making a “shared responsibility payment” (aka a tax penalty).
For failing to carry health insurance in 2017, the maximum penalty on your household’s taxes will be the total yearly premium of a bronze plan sold on the marketplace (based on a national average) or $2,085 — whichever is higher. You can see the two different ways to calculate the number for your household here, on HealthCare.gov.
The penalty amount for failure to be covered in 2018 has not been announced, but you can expect it to be higher due to inflation, according to the government site.
What’s your health coverage plan for the coming year? Share with us in comments below or on our Facebook page.
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