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How Will a Shorter Enrollment Period Affect the ACA?

by EINSURANCE

How Will a Shorter Enrollment Period Affect the ACA?

The ACA was originally written to reduce open enrollment availability starting in fall 2018 for 2019 coverage. But, the Centers for Medicare and Medicaid Services (CMS) has shortened the open enrollment period for the Affordable Care Act (ACA) a year prior to planned. Instead of keeping enrollment open from November 1 to January 31, enrollment for 2018 will now be open November 1, 2017 to December 15, 2017.

Why Was the Enrollment Period Reduced?

The stated reason for cutting back on the open enrollment period for ACA is to stabilize the individual health insurance market, but that reasoning is controversial for some. According to healthaffairs.org, by opening enrollment for only 45 days, as opposed to three months, there could be reduced enrollment among healthy people, who statistically have enrolled later in the process. Plan-switchers have also tended to enroll in the last half of the three-month open enrollment period.

Other Changes in the Rules

Additional new rules also have the potential to disrupt participation.

  • Insurers can now require former policy holder to pay any past-due premiums before enrolling with the same carrier for 2018.
  • The Internal Revenue Service will no longer reject returns that do not indicate that health coverage was maintained throughout the tax year. However, tax penalties remain in place, unless Congress decides otherwise.
  • The budget for promotional advertising to make sure people are aware of the open enrollment period and where they can find help with the process has been cut by more than 90%. The advertising budget will now be on par with that of Medicare and Medicaid.
  • Grants intended for ACA “navigators”, who provide free face-to-face assistance to people having trouble understanding the paperwork and applications, have been cut by 41%.

Exceptions for State-Run Exchanges

While states that rely on HealthCare.gov must follow the new reduced enrollment period, some leeway is being given to states that run independent exchanges. Some states, such as California, are taking steps to ensure that the state’s exchange enrollment is extended in the coming years as well.

As of early September, eight states and the District or Columbia had extended open enrollment on their exchanges. The states are: California, Colorado, Connecticut, Massachusetts, Minnesota, New York, Rhode Island and Washington.

The state-run exchanges that are extending enrollment have varying closing dates, but generally have slated closure of open enrollment for mid to late January. Connecticut, however, will allow enrollment until December 22.

Coverage will begin January 1, 2018 for people who enroll in the ACA in exchange states that stay with the new December 15 Federal enrollment deadline. According to National Association of Professional Agents (NAPA), in states where enrollment has been extended, deadlines will vary. Generally, coverage will begin in February or March, with some exceptions:

  • In Rhode Island plans will go into effect January 1, although enrollment can occur as late as December 31, 2017.
  • Plans will be effective on January 1 in Connecticut, too.
  • In Massachusetts, which will continue open enrollment through January 23, 2018, anyone who enrolls before December 24 will be covered starting January 1, 2018; those who enroll between December 24 and January 23 will see coverage be effective February 1.
  • In Connecticut, where the deadline will be December 22, all insurance will be effective as of January 1.

To see a list of all state exchanges, go to HealthCare.gov.

Extension for Hurricane Victims

A special enrollment period (SEP) has been established for people hardest hit by 2017’s Hurricane Irma and Hurricane Harvey. For these areas, enrollment will continue until December 31. All of Florida was granted an extension, as were seven counties in Georgia and 47 in Texas.

Other Special Enrollment Periods

Whether you purchase insurance through an exchange or not, you are allowed to enroll outside of the open enrollment period if you have experienced a qualifying event. (The exception is for people living in Nevada, where you can purchase insurance outside of the exchange year-round.)

Examples of qualifying events include:

  • Birth or adoption
  • Marriage
  • Becoming a U.S. citizen
  • Loss of job or other involuntary loss of health coverage
  • Moving to an area that offers different health plans

For more information about the special enrollment period see ACA Special Enrollment Period: Do You Qualify? on einsurance.com.

So, What Now?

Nobody knows with certainty what effects the shortened open enrollment period and other rule changes will have on the number of people who get health insurance coverage. To make sure you are not adversely affected, find out the deadlines that apply to you. On November 1, start researching your plan options. Then, make it your goal to get your application completed and submitted at least a week before open enrollment closes.

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