Getting the Word Out About Open Enrollment 2018
If you can share that message with at least one person, then you’ve done a lot to help.
To share that message, please consider signing up for our ThunderClap campaigns.
How ThunderClap Works: Click the link and then “Support” the campaign to help spread the word about Open Enrollment for 2018 coverage. Supporting the campaign means that ThunderClap will post this one-time message to your account on November 01 at 12:00 PM EDT.
TIP: For more you can do to support the Affordable Care Act this open enrollment (like signing up for a marketplace account or taking advantage of other aspects of the ACA), keep reading.
The Basics of the ACA and Open Enrollment
What is the Affordable Care Act (ACA or ObamaCare)? The Affordable Care Act (ACA) is a health care reform law enacted in March 2010. The law provides consumers with subsidies that lower health insurance costs for households with incomes between 100% and 400% of the federal poverty level, expands Medicaid, expands employer coverage, and reforms the healthcare industry.
What is open enrollment? Open enrollment is the time when individuals and families can enroll in a health plan that qualifies for cost assistance (for example, by shopping at the official Health Insurance Marketplace HealthCare.Gov). Open enrollment happens at the end of each year, allowing individuals and families to purchase health plans that will cover them for the upcoming year. So for open enrollment 2018, individuals and families can enroll in 2018 health plans from Nov 1st until Dec 15th, 2017. Then, assuming they make the deadline, their plan will start Jan. 1st, 2018. Those who miss the deadline will find their options limited.
IMPORTANT: Despite President Trump ending Cost-sharing Reduction (CSR) subsidies to insurers, insurers must still provide reduced out-of-pocket costs and deductibles to those earning under 250% of the Federal Poverty Level (FPL). This resulted in significant increases in the premiums for Silver Plans in particular. However, Premium Tax Credits (PTC) are calculated based on the Second Lowest Cost Silver Plan. Those earning under 400% of FPL eligible for PTC will receive more tax credits which can be used for any Marketplace plan. It means more federal spending (then simply covering the CSR), as well as, very high premiums for those who earn over 400% FPL, but many earning under 400% FPL will find Marketplace plans are more affordable.
Why Open Enrollment 2018 Matters
If you pair that with the fact that the administration shortened open enrollment by a month and a half (it was originally slated to end Jan 31st, 2018) and the fact that HHS announced HealthCare.Gov won’t be open on Sunday mornings this year, you’ll get a sense of why it is more important than ever that we all work together to ensure everyone is covered.
The bottom line here is simple, if sign ups are low this open enrollment, it will give opponents of the Affordable Care Act an excuse to dismantle the program. If on the other hand, we all work together to get the word out, it will help show America that we the people support the Affordable Care Act.
Help us spread the word about open enrollment 2018 and remind people to sign up at HealthCare.Gov or their state’s marketplace between Nov 1st and Dec 15th, 2017 (deadline extended in some states). And of course, don’t forget to get covered yourself!
One of the ways you can show support for the ACA or specific provisions of the ACA is using the ones you are eligible for. That means signing up for coverage:
- through your employer or the marketplace
- getting cost assistance if you are eligible
- enrolling in Medicaid or CHIP if you are eligible
Beyond that, simply ensuring you get coverage this year will help to show that Americans want health coverage and don’t want to return to a system that excludes upwards of 50 million people (like it was before the Affordable Care Act).
TIP: Open Enrollment for Marketplace insurance ends on December 15th, 2017. After midnight on December 14th, you’ll need to qualify for a Special Enrollment Period to enroll in a Marketplace plan (some states have extended their open enrollment).
FACT: Changes have also been made to HHS policy that will affect 2018 Special Enrollment eligibility. You’ll need to provide documentation proving eligibility for Special Enrollment to purchase Marketplace coverage after December 14th, 2017.
FACT: The 2018 Open Enrollment period is shorter than 2017 because of HHS policy changes under the Trump administration.
Who Should Sign Up?
Every citizen should enroll in coverage this year, and any citizen not eligible for Medicare or employer coverage should at least create a marketplace account (on HealthCare.Gov or their state marketplace).
Aside for those on Medicare, everyone is eligible to use the Marketplaces to shop for and purchase health insurance even if they are not eligible for cost assistance. Thus, it is appropriate for any tax filer not on Medicare to create a marketplace account, use it to compare plans/insurers, and enroll in the health insurance plan that is best for your family!
When you sign up for an account, you will find out if you are eligible for cost assistance or qualify for Medicaid/CHIP.
With that in mind, even without cost assistance, many will find marketplace plans to be the most affordable option in their region.
FACT: Open Enrollment is the best time to consider your options and make the best health insurance decisions you can to be covered for 2018, as it is the only time in which individuals and families can enroll in coverage without qualifying for a Special Enrollment period.
Signing Up For Medicare and Employer Coverage
Everyone should enroll in health insurance during their insurer’s annual enrollment period if they want to support the Affordable Care Act and they are entitled to enroll; this includes those eligible for Medicare and employer coverage.
The Affordable Care Act improved Medicare and expanded employer coverage, so sign-ups in those markets will help too.
It is important to note that not all insurance types have the same Open Enrollment Period or Special Enrollment eligibility rules, so make sure to familiarize yourself with the specific rules of your type (for example with Medicare and employer coverage).
FACT: If you are offered another form of insurance (like Medicare or “Affordable” Employer Coverage) you are not typically qualified for Marketplace cost assistance, but you still might qualify for Medicaid, CHIP, or an exemption from owing the fee for not having minimum essential coverage.
Show Support for the Affordable Care Act
One of the ways you can show support for the ACA or specific provisions of the ACA is using the ones for which you are eligible and it often surprises people what assistance they are eligible for.
Enrolling in coverage with cost assistance is the obvious one, but there are more provisions of the law than that you may be eligible for and should consider utilizing.
Here are some of the things you might be eligible for:
Premium Tax Credits – If you are eligible for assistance through the Marketplace and earn under 400% of the federal poverty level, you will find that Premium Tax Credits (PTC) will offset the increases in premiums created by the President’s Executive Order ending Cost-Sharing Reduction subsidies payments TO insurers because the amount of PTC a person is eligible for is based on the price of the Silver Plans and your income. Find out whether you are eligible PTCs through Healthcare.gov or your State’s Marketplace.
Cost-Sharing Reductions – Despite not receiving Cost-Sharing Reduction subsidy payments, insurers must still provide reduced out-of-pocket costs and deductibles on Silver Plans to those earning under 250% of the federal poverty level and eligible for cost assistance through the Marketplaces. Find out whether you are eligible CSR through Healthcare.gov or your State’s Marketplace.
Medicaid Expansion – If you live in a state that expanded Medicaid to income levels up to 138% for non-disabled adults and you are eligible, sign up. Expanded Medicaid includes state alternatives to traditional Medicaid Expansion programs like Healthy Indiana Plan 2.0 too.
FACT: Being offered employer-sponsored coverage doesn’t in anyway affect Medicaid eligibility, but income eligibility guidelines vary in non-expansion states. Apply for Medicaid in your State to find out if you qualify.
Medicaid in the Non-Expansion States – If you live in a state that hasn’t expanded Medicaid and you would have been eligible if they had, you can still sign up. It’s one way to show support for Medicaid expansion in your state. You’ll also get an exemption from the requirement to have insurance or pay the fee for not having it simply because you took the time to be denied (even if you’re offered and enroll in an employer-sponsored coverage). Those who are denied Medicaid because their state didn’t expand may also qualify for low-cost catastrophic coverage.
FACT: There is no enrollment period for Medicaid or CHIP. You can apply for Medicaid or CHIP anytime during the year.
Families With Children – Even if your income is too high for Medicaid in your state, your children may still qualify for CHIP coverage depending on your state and your families income level. This is true even if they are offered employer-sponsored coverage. If you think your children might be eligible, please apply for your state’s CHIP program.
FACT: Being offered employer-sponsored coverage doesn’t in anyway affect CHIP eligibility. You can apply for CHIP anytime during the year.
Non-custodial Parents – If you are not the custodial parent of your child you may still want to or be required to purchase health insurance for your children. Unfortunately, there is only one way for you to be eligible for Marketplace cost assistance based on your income. The custodial parent can elect to divide up the tax credits and deductions related to the children so that the non-custodial parent be eligible for cost assistance to cover them. Having a non-custodial parent insure the children requires a tax form signed by the custodial parent and does not always create the best tax situations for families as a whole. You need to make sure you talk it over with the other parent (and maybe an accountant) before open enrollment ends.
Those who are Eligible for Medicare – If you qualify for Medicare (receive SSI or SSDI), you may still qualify for assistance through Medicaid in your state. If your income is below 138% FPL in a state that expanded Medicaid, you are considered “Dual Eligible.” How states assist dual eligible individuals and how potentially eligible individuals apply for that assistance varies widely from state to state, so you’ll need to check with your state’s Health Care Authority to find out how to find out how to apply in your state.
Those who Qualify for Indian Health Coverage Exemption – If you qualify for Tribal health benefits, you are exempt from the fee for not having minimum essential coverage. Signing up for Marketplace insurance or Medicaid if you are eligible results in your Tribal Health providers getting reimbursed for the care they provide in addition to normal federal funding. As an added perk, tribal members can enroll in a marketplace plan with no cost-sharing and are never subject to cost sharing when receiving care at tribal health facilities.
Those who Qualify for a Hardship Exemption – There have been no proposed changes to the previous administration’s HHS guidance on what constitutes a “Hardship” of eligibility for this exemption. If you are experiencing a financial hardship, you may be eligible, but you must apply and be approved to avoid owing the fee.
FACT: The best time to have a hardship is never. The best time to apply for a hardship exemption is ASAP after experiencing financial hardship. The best time to learn what qualifies as a hardship is now.
NOTE: If you do qualify for an exemption, you should still try to get health insurance coverage for you and your family. You’ll be eligible to purchase a catastrophic coverage through the marketplaces.
Those who Qualify for Catastrophic Health Coverage – Those under the age of 30 and those with a hardship exemption are eligible to purchase Catastrophic coverage on the Marketplaces. While the out-of-pocket costs are high with these types of plans, they do provide preventative coverage at no cost, generally have much more reasonable premiums, can sometimes be paired with HSAs to maximize tax benefits, and it will provide good coverage if you have catastrophic health costs. If you are not able to afford more comprehensive coverage, catastrophic plans will provide a stop gap to protect you and your family in the event of a health crisis.
Those who Still Can’t Find Affordable Coverage! – If you still having difficulty finding the coverage you can afford for 2018, there are a few more places you can look.
- Consider health insurance options available off-marketplace. Many insurers offer the same plans on and off the Marketplaces. Those who aren’t eligible for cost assistance may find these plans are more affordable.
- Consider having the most limited gap in coverage as possible during 2018. Every person is eligible for a Short Term Gap exemption, but you can only sign up for health insurance plans during their open enrollment period (unless you qualify for Special Enrollment).