Obamacare health plans still available despite uncertainty over law's future
Health advocates are reminding people of the available options.
— -- On Wednesday, Nov. 1, insurance marketplaces will begin open enrollment for the Affordable Care Act, or Obamacare. But with so much attention focused on the debate surrounding repealing the law, many are bewildered about their coverage options through the law, or if there will even be insurance to buy.
“The marketplace is not repealed and is very much alive,” said Sara Collins, vice president for health care coverage and access at the Commonwealth Fund, a nonpartisan health care advocacy group. While there may be some uncertainty about the long-term stability of insurance marketplaces, given the congressional confusion on financial support, it is important for consumers to focus on the fact that Congress has not repealed the Affordable Care Act.
There are, however, some important differences this year for consumers to note if they would like to obtain health coverage.
Most importantly: consumers have less time to buy insurance on the exchanges than ever before. While some states have extended their open enrollment period, this year’s open enrollment is shorter by 45 days compared to last year. Open enrollment starts Nov. 1, and many consumers will have until Dec. 15, 2017, to buy their insurance plans for 2018.
After Dec. 15, those without insurance will only be able to purchase a plan if they qualify for the so-called special enrollment period, typically because of “certain life events, like getting married, having a baby, or losing other health coverage,” according to healthcare.gov.
Additionally, planned website down times may make healthcare.gov, the main portal for consumers to apply for coverage, periodically unavailable. It was reported earlier that these new web down times may occur every Sunday from midnight to noon, during what was a convenient time for families to convene and discuss finances.
The other important piece to note: price. After a year of being inundated with headlines about skyrocketing costs of insurance, health care may feel like an unaffordable luxury to many. For some, there may be increases in premiums, “but most people who buy on the marketplace are eligible for help, and they won’t see these big increases,” says Collins. “Some people might even see premiums go down.”
Most Americans receive health care from their employer, and the current fight over the Affordable Care Act is not expected to directly affect the coverage that these people receive. “None of the policy activity this year, including efforts to repeal and changes from Trump, have any implications for employer based coverage,” says Collins.
But for those who do not receive healthcare from their employer or Medicare, Americans can still go to healthcare.gov to shop for care. Even before Nov. 1, users can preview costs for plans for next year, shop for the plan that is best for them, and compare offerings for different level plans based on the amount of support for which they’re eligible. Some users might see large savings in monthly premiums as well as deductions in their out-of-pocket costs.
Marketplace plans are divided into three tiers: silver plans, which are considered the benchmark with the most standard coverage; gold plans, which are more expensive and usually appeal to people anticipating the need for more care; and bronze plans, considered riskier, with lower monthly costs but higher out-of-pocket costs when care is needed. Collins noted that this year, premium increases may cause subsidies to rise on the more expensive plans. “People may be surprised to find that gold plans are cheaper than they were last year.”
For those whose eyes glaze over at talk of subsidies, premiums, cost-sharing and tax credits, there is help. Healthcare.gov incorporates available benefits, based on family size and income, into the price you see for your plan on the website. Consumers need to consider how much they want to pay per month, and what to payments to make. For those needing guidance, there is a helpline staffed 24 hours a day, seven days a week, at 1-800-318-2596. It is closed Memorial Day, July 4, Labor Day, Thanksgiving Day, and Christmas Day.
For those who already bought a plan on the marketplace last year, Collins still suggests going to healthcare.gov to confirm that it will be offered next year, and that the price hasn’t changed drastically. Because of many of the changes, it is actually possible that consumers who had previously bought plans with which they are happy are eligible for plans with cheaper premiums or better coverage.
Despite the perception of uncertainty, Americans will have access to health care coverage through the ACA in 2018. “For people in the marketplaces, maybe you lost a job or just don’t have insurance, the ACA is still law of the land, and the marketplaces are up and running,” says Collins. “For everyone, it’s good to buy a plan, understand its costs, and what’s covered.”