ACA open enrollment season is underway.
November 1 is the kickoff date in most states for a six week period for enrolling in health insurance under the Affordable Care Act (ACA). California’s signup period started on October 15 and runs through January 15. Washington, DC and New York also have three-month open enrollments, each running from November 1 to January 31. Rhode Island’s lasts until December 31, and Colorado, Massachusetts, and Minnesota stay open through mid-January.
Average premiums are a little lower.
After big premium increases last year (37 percent on average for the most popular type of coverage, the silver plan, in states that let the federal government run their ACA marketplaces), average premium rates are set to decrease by 1.5 percent for 2019. Next year more insurance companies will be participating in the ACA marketplaces, and fewer people will have only one insurance company selling ACA plans in their area.
Silver premiums could have been 16% lower if not for actions taken in 2017 and 2018 to eliminate cost-sharing subsidies, repeal the individual mandate, and expand non-ACA-compliant short-term plans and association health plans, according to a Kaiser Family Foundation analysis.
States took action to strengthen their insurance markets.
Some states took action this year to rein in premiums, sometimes with the support of the federal government. Maine, Maryland, New Jersey, and Wisconsin were granted permission from Washington to establish reinsurance programs, where the state helps insurance companies pay for enrollees with high health care costs. Maryland, for example, said that without reinsurance average individual market premiums would have gone up 30%; instead, they went down 13%.
Other states tried to counter federal policy decisions. New Jersey and Washington, DC passed individual health insurance mandates set to take effect when the national mandate penalty falls to $0. California, Hawaii, Maryland, and Vermont passed laws to restrict the non-ACA-compliant health plans that the federal government was trying to expand.
There are new kinds of plans to consider, but less help for shoppers.
For the first time, consumers in many states will have an option outside the ACA marketplace, like a short-term or association health plan, that is cheaper because it covers fewer benefits or screens out sick people. As AOTA previously reported, these plans could have little or no coverage for occupational therapy. Under new federal policies, short-term health insurance can last as long as three years, and more self-employed people can sign up for association health plans. Since 2016, the federal government has cut funding for the “Navigators” who provide enrollment assistance to potential ACA marketplace enrollees by 84%, so there will be less access to personalized assistance for people comparing comprehensive plans with the new, less comprehensive options.
Reading the fine print is more important than ever.
Because there will be options in many states that don’t have to provide patient protections and benefits that used to be mandatory for plans sold to people who buy their own insurance, it is more important than ever to thoroughly review plan benefits. The Kaiser Family Foundation has a guide for consumers considering short-term plans during open enrollment.
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