Health Care Open Enrollment: What You Need to Know

By Lena O'Rourke

The Affordable Care Act (ACA) is still law, despite many repeal attempts and ongoing sabotage by the Trump Administration. On November 1, people who buy health insurance through the individual marketplace can begin shopping for coverage for 2018. Open enrollment will also begin for low-income people who qualify for Medicaid. 

Federal open enrollment begins on November 1 and ends on December 15. This is the only time of year many people will be able to purchase coverage from the marketplace. Open enrollment is significantly shorter than in past years.

Unfortunately, the people who most need insurance may not be aware it’s available and affordable. The Administration has severely scaled back outreach and enrollment efforts, including those targeted to low-income people as well as communities of color

Health care providers, schools, child care centers, and other community-based groups play a vital role in linking people who need health insurance to coverage during open enrollment. Here’s what you need to know:

1. Healthcare.gov is open for business!

It’s now open enrollment. Consumers who need health insurance for 2018 can buy it now. 

During open enrollment, individuals and families can purchase health insurance through the federal marketplace (healthcare.gov) or your state marketplace. These plans cover a guaranteed benefit package, and significant financial help is available based on income and family status. 

2. Open Enrollment starts on November 1 and ends on December 15! 

For most people, open enrollment is the only time they can purchase insurance through the marketplace. Medicaid enrollment is open year-round; however, people who don’t know which program they’re eligible for should apply through the marketplace. If they’re eligible for Medicaid, they’ll be connected automatically.

In 43 states, individuals must enroll between November 1 and December 15, 2017, for coverage in 2018. The remaining states, as well as the District of Columbia, have extended open enrollment:

    • California: January 31, 2018;
    • Colorado: January 12, 2018;
    • Connecticut: December 22, 2017;
    • District of Columbia: January 31, 2018;
    • Massachusetts: January 23, 2018;
    • Minnesota: January 14, 2018;
    • New York: January 31, 2018;
    • Rhode Island: December 31, 2017; and
    • Washington: January 15, 2018.

When open enrollment ends, most people won’t have another opportunity to buy 2018 coverage from the marketplace. There is only a small number of qualifying “life changes” that can trigger a special enrollment period later in the year. However, Medicaid enrollment remains year-round. 

3.    Financial assistance is available!

Tax credits and cost-sharing reductions (CSRs) are still available for those enrolling through the marketplace. Generally, people earning 100 to 400 percent of poverty will be eligible for tax credits to reduce their monthly premium payments. People earning 100 to 250 percent of poverty will also be eligible for CSRs to reduce their out-of-pocket costs, such as co-pays and deductibles. Despite rampant talks about cutting financial assistance, no changes have been made that will affect people enrolling through the marketplace.

4.    Shop around!

Healthcare.gov (or your state’s marketplace) makes it easy to compare health plans in a geographic area.

It’s important to know your options. People who already have coverage through the marketplace should still shop around. During open enrollment, many people discover that switching plans can reduce their premiums or improve their coverage. The deadline to change coverage is December 15.

5.    Ask for help!

Free in-person help is available from trained professionals. If an individual has questions or wants help with their application, they can visit localhelp.healthcare.gov to find in-person assistance. Or they can call 1-800-318-2596 to ask questions and apply through the national Call Center. The Call Center offers help in many languages. 

6.    Spread the word!

Know someone who needs health insurance? Spread the word. Open Enrollment is short this year—and outreach is limited. Share this information with anyone you know who needs health insurance.