By Sy Mukherjee
November 1, 2017

Despite multiple attempts by a GOP-led Congress and President Donald Trump’s administration to repeal and replace Obamacare, formally known as the Affordable Care Act, over the past year, it remains the law of the land. In fact, Obamacare open enrollment begins this week, and its requirement that almost all Americans carry health insurance is still in effect.

There’s a lot of confusion out there about open enrollment season for Obamacare. After all, Trump recently decided to cut off important Obamacare subsidies paid to insurance companies to help lower out-of-pocket medical costs for low-income Americans. Trump has also signed executive orders scaling back certain requirements on insurance companies and essentially made enrollment outreach a non-priority by cutting off funding. The latter move has navigators who help people sign up for insurance coverage concerned that many will neglect to take advantage of open enrollment out of uncertainty or because they simply don’t know Obamacare is even around anymore; a new analysis by S&P Global Market Intelligence finds Trump’s moves may lead to 1.6 million fewer Americans signing up for individual health insurance plans in 2018 compared to 2017.

Here are some of the most important things to know about Obamacare open enrollment for 2018 in this tumultuous time.

What is health insurance open enrollment?

Open enrollment is a period during which people can buy health insurance coverage for the upcoming year. The reason that there’s a set amount of time each year for open enrollment is a socioeconomic one: It’s to prevent people from only buying insurance when they’re sick. This way, health plan holders have coverage throughout the year (provided that they pay their monthly insurance premiums) and insurers don’t have to worry about only receiving someone’s premiums when they develop a more costly medical need.

When is open enrollment for Obamacare 2018?

The 2018 Obamacare open enrollment season runs from Wednesday, Nov. 1 through Dec. 15. That’s a shorter open enrollment period than in previous years. Open enrollment for other kinds of insurance, like health plans offered by your employer, may be different. For instance, those may occur during the last two weeks of October or another designated period worked out by the employer and health insurers whose plans they offer.

Former President Barack Obama took to Twitter to remind social media users about the enrollment season Wednesday.

 

How do you sign up for Obamacare?

If you don’t have insurance coverage through your employer or a public health insurance program like Medicare or Medicaid (as the vast majority of Americans do), you can sign up for private individual health insurance plans on Obamacare’s marketplaces through Healthcare.gov. (Some states manage their own Obamacare marketplaces rather than using Healthcare.gov, but you can get to those through the federal site, too).

It’s possible to sign up for private Obamacare plans outside of this open enrollment period under certain special circumstances, like if you lose your job, move, or get married. Americans with low enough incomes to qualify for Medicaid (which was significantly expanded in many states under Obamacare) can enroll in that program at any time of the year.

Obamacare coverage for 2018 purchased during the open enrollment period kicks in on January 1, 2018.

When is the deadline for Obamacare open enrollment?

The deadline for Obamacare enrollment is December 15 in most states. However, some states which run their own Obamacare marketplaces may choose to extend their deadlines in order to allow more people to sign up (many have chosen to do this in the past). Check your state’s Department of Health’s website to figure out whether or not you have some extra time to sign up for health insurance coverage.

Obamacare premiums increase in 2018

You’ve probably heard that Obamacare premiums are on the rise. This is true, for a variety of reasons—but that doesn’t mean you’ll necessarily have to pay more money.

People earning between 100% and 400% of the Federal Poverty Level (FPL) qualify for federal tax credits which help them pay their monthly health insurance premiums for private Obamacare plans. The less your income, the more generous the tax credit. In some cases, depending on how generous the kind of plan you buy is—basic catastrophic coverage, Bronze, Silver, Gold, or Platinum—and your income, you may actually be able to get a plan for no money at all, as the nonprofit Kaiser Family Foundation’s Larry Levitt explains.

Plans with lower premiums also tend to come with higher deductibles and yearly out-of-pocket maximums.

Ironically, federal subsidies have actually become more generous for Obamacare plans this year because of Trump’s decision to cut off the other kind of Obamacare subsidies—the ones made to insurance companies rather than consumers and which the president has dubbed an insurance company “bailout.” Those payments to health insurers are doled out in exchange for the firms lowering the out-of-pocket costs paid by individuals or families who opt for a mid-level “Silver” Obamacare plan and earn up to 250% of the Federal Poverty Level.

The thing is, insurance companies still have to offer that financial benefit to qualifying Obamacare customers whether or not Trump makes the payments. And many had already assumed he would follow through on the threat to end the subsidies. So, in preparation for that, many participating Obamacare insurers proactively raised certain Silver plan premiums for 2018. And since the level of federal tax credit subsidies to help consumers pay their premiums is based on the average cost of “benchmark” Silver plans, that actually means 2018 Obamacare customers who qualify for assistance will receive more generous health premium subsidies. However, Americans who make too much money to be eligible for the subsidies and buy individual insurance will have to swallow those increases.

The moral of the story: If you’re looking for a private individual health insurance plan during this Obamacare open enrollment season, make sure to shop around.

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