ACA Open Enrollment starts at 12:00.00001 AM on Sunday morning.
Open enrollment goes through at least December 15th for everyone. Healthcare.gov is the federally run exchange. States that run their own exchanges may go longer.
So what do you need to know about Open Enrollment?
TAKE A MOMENT
You don’t need to make a choice this weekend. There might be other things that are grabbing most if not all of your attention at the moment. I know my attention is scattered.
TAKE A LOOK
You might be perfectly happy with the choice that you made this year and want to continue with that same choice next year. If you are not receiving a subsidy, you should have gotten a letter in the past week saying that Plan X will cost you $Y starting in January. Premium increases this year were fairly low.
If you received a subsidy, it is critical to look at the exchanges. Your net premium is a function of your income (which could change since the last time you entered your information) and the premium spread between the plan you chose last year and used this year and the benchmark plan. The benchmark plan is fairly likely to change in competitive markets. It is very likely to change. Your gross premium might be flat or decreasing but your net premium (the number you actually care about) could sky rocket because a new insurer came into the market and undercut the benchmark.
Taking a look at all of the options out there is critical. You do not need to make a perfect choice. You just need to make a good enough choice. The subsidy formula does weird things to relative prices which does weird things to the price you pay, so look around so you are not surprised. And hell, there may be a great deal out there.
TAKE A HAND
Insurance is confusing. I say that as someone who thinks about insurance way too much. Unless you know you are nearly certain to run up $40,000 or more in claims every year, figuring out the interaction of cost sharing, risk tolerance, and potential medical expenses is tough. Get help. The ACA has navigators to help understand plans and the enrollment process. They can’t make a recommendation but they can lay out the choice space. Agents and brokers can and will make recommendations (as that is how they make their money) and the better ones really know the ins-outs and oddities of policies.
TAKE A BREATH
This is a big and complex decision. Laying out your priorities, values, and realistic constraints is important to make the pragmatic decision space smaller. Once the decision space is reduced down to a couple of good enough choices, take a breath and accept that good enough is likely good enough as optimal choice can be extremely hard to make. Accepting that these choice sets are satisficing solutions instead of optimizing/maximizing solutions is a big relaxer for me.
Anonymous At Work
Important to Enroll If you can: Supreme Court doesn’t cite poll results in their opinions, but the Justices do read the polls. And ACA Enrollment would be a “poll” for how many people they’ll piss off if they cancel the ACA.
There go two miscreants
“There might be other things…”
Droll. Very droll. (But seriously I am grateful for your posts — I always learn something.)
David Anderson
@Anonymous At Work: SCOTUS will follow the election results far more closely than they will follow enrollment counts.
germy
If someone loses their job (and insurance) in February or March, can they enroll? Or do they need to wait until Nov.?
Butch
Just got a notice that my premium will go up $120 a month with the same subsidy and some unfavorable changes in deductibles. I used the insurance exactly once all year, for a flu shot, so I’m thinking I go with a cheaper plan?
Omnes Omnibus
@germy: You can always get insurance through the exchanges if you have a life event that suddenly makes you eligible. Losing a job is one such event.
germy
@Omnes Omnibus:
Thank you.
David Anderson
@germy: If you lose coverage due to job loss in the middle of the year, you can get a Special Enrollment Period to sign up mid-year.
germy
@David Anderson:
This is good to know.
WaterGirl
Dave, do you have a link that you can post? For where folks can go online to start the process?
I’m thinking that would be one less hurdle people would have to jump in order to start what can feel like a very intimidating process.
Anonymous At Work
@David Anderson: True but 52 Democrats in the Senate with a 10% increase in West Virginians enrolled would make a difference on Manchin’s vote for packing the court, should they overturn ACA. Every enrollee counts, until Dems hit 60/63 (PR & DC) in the Senate.
Another Scott
@David Anderson: Several Democrats were yelling at Donnie and HHS to create a special Open Enrollment at the start of the pandemic. They said “No”. (Warning – Politico.)
I’m confused as to what the Democrats were requesting and why, since unemployment is a “life event”. Were there other people who didn’t qualify under a “life event” that a special Open Enrollment would cover?
Thanks.
Cheers,
Scott.
Wesley Sanders
@Another Scott: Unemployment itself isn’t a life event. Only loss of coverage is. So this would have opened it up to a much larger group of people than just those who lost their job-based insurance.
Yarrow
Thanks for the reminder, David. If the Supreme Court invalidates the ACA will people who have health insurance for 2021 get to keep it? Or will it go away immediately? I understand they hear the case in November but the ruling won’t come down until next year, right? Or will there be some special announcement asap so the 2021 open enrollment can be invalidated?
This is all so incredibly stressful. As I’ve said before, my government wants to kill me. Or, as Rep. Alan Grayson said back in 2009, “Republicans want you to die quickly.” Same now as it was then but with added pandemic.
Anonymous At Work
@Yarrow: Depends on the exact wording of the opinion.
BUT (!!!) SCOTUS could give itself another out, ruling that a mandate set to 0 isn’t a tax, threatening the entire Act, and send the case back to district court to determine how to deal with current enrollees. Democrats set mandate to a penny (peppercorn, thank you Contracts Law) and claim the entire suit is mooted.
HOWEVER, that approach might only get 4 votes (Roberts and 3 liberals).
Frank McCormick
I am so glad I don’t have to deal with this anymore.
Yes, the ACA saved my life — but the problem is that it is full of insurance companies <grin>.
Kelly
I’ll transition to Medicare mid-year. Mrs Kelly will remain on ACA coverage for a few more years. Weirdly the ACA subsidy will go from $1375 for the two of us to $377 for Mrs Kelly alone. If we stay with our Kaiser Bronze HSA plan the monthly cost will go from under $10 for the two of us to $272 for Mrs Kelly alone. Plus whatever I settle on for Medicare, probably Kaiser Medicare Advantage, 3 tiers from $0 to $127 monthly.