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Marketplace Editors - Healthcare Marketplace | Enroll in 2017 Obamacare Plans

Why Sign Up For 2017 Coverage?

Are you tired of getting reminders by email or mail to sign up for 2017 coverage under the Affordable Care Act? Since President Trump has been elected, you may think that signing up is a waste of time, particularly if you don’t expect to see a doctor this year. After all, President Trump is going to abolish the ACA anyway, right? It’s true that healthcare in America is about to face major changes under the new administration, but don’t be too quick to shrug off coverage as pointless or unnecessary. There’s always a good reason to get health insurance. Here are a few for 2017.

Trump Might Change His Mind

President Trump spoke firmly against Obamacare during his campaign, making it crystal clear that his intent was to repeal the law. Since taking office, however, his views have seemed to change considerably. At the very least, Trump has openly admitted that he supports one of the major tenants of the bill. He wants to make sure enrollees can’t be denied coverage by insurers for having a pre-existing condition.

But there are exceptions to this. Republican plans may allow insurance carriers to reject applicants who have a pre-existing condition and whose coverage has not been continuous. In other words, if you were unemployed temporarily and decided not to buy coverage, but you try to sign up again once you’re back on track, you may be denied or charged higher premium rates. This is one good reason that people with pre-existing conditions need to take advantage of the law’s protections for this year. Under the ACA, insurers can’t deny your application for coverage based on medical condition, and you can’t be charged higher premium rates. Sign up in 2017 to enjoy the full benefits of the law before they change.

Benefits Won’t Disappear in 2017

You may believe that because Trump plans to demolish Obamacare that you won’t have coverage under it even if you enroll this year. It’s one of the top concerns among consumers going into the 2017 plan year. But policy experts don’t think this is the case. In fact, many experts don’t think Americans should worry about major changes taking place in 2017. Elizabeth Hagan, a senior policy analyst at Families USA, said that those enrolled in the ACA this year will be covered until 2018. In other words, nobody knows what’s going to happen after 2017, but your coverage will be good through at least this year.

A New Proposal Could Keep Things the Same

Earlier this week, four Republican senators put together the Patient Freedom Act, which is a bill that, if enacted, offers individual states the ability to choose between three options for healthcare:

  • Retain some of the provisions of the ACA while limiting subsidies.
  • Implement the proposed plan for health savings accounts paired with high-deductible health plans and receive federal grants or refundable tax credits.

Design an alternative plan without federal assistance.

Essentially, this means that states might choose an option that effectively keeps much of the Affordable Care Act intact, marketplaces and all. It’s unlikely that President Trump and his supporters will support this, but the fact that an option like this exists means that some Republican lawmakers are willing to strike a deal with their Democratic opponents. Having health insurance in 2017 will help you weather the storm, regardless of what happens in Washington.

Republicans Have Promised a Transition Period

Republicans have pledged that if they do repeal Obamacare, they will offer a transition period to people who are covered under ACA plans so that they won’t be left without coverage. What this “transition period” will look like is uncertain. What is clear is that people who buy health insurance for 2017 will be able to keep those plans at least until something official gets adopted by the new administration.

The Future Isn’t Set in Stone

Political commentators have questioned whether President Trump will actually go forward with his plans to repeal the Affordable Care Act. From a political standpoint, kicking 20 million people off of their health insurance would be disastrous, even for people who didn’t support the law in the first place. Enrollment surged after Trump was elected, and signups continue to increase despite uncertainty about the future of Obamacare. Some experts suspect that increased signups this year could change the new administration’s mind about replacing the ACA. If you sign up for health insurance this year, you may be sending a message to Washington that coverage matters to you, along with the other 11.6 million people who’ve already signed up for 2017.

You May Still Be Fined

Several executive orders signed by President Trump this week raised questions about the future of the individual mandate, the penalty charged to people who don’t get health insurance for the year. While there are doubts about whether people will be fined next tax season, right now, your best bet to avoid the fine is to enroll in an ACA-compliant health plan. The deadline to sign up is January 31. If you don’t have coverage, you could pay $695 or 2.5 percent of your taxable income, whichever is higher.

Aside from the penalty cost, there are other financial reasons to get health insurance, not least of which is the fact that medical bills can stack up before you know it. Take charge of your family’s healthcare in 2017, and enroll in a qualified health plan today.

Grants to Help with Consumer Protections

The Affordable Care Act created grant programs designed to help states oversee and enforce market reforms, and guarantee consumer protection for those using the new health care marketplace systems. To assist each state with its health insurance rate review processes, $250 million was made available to monitor insurance companies and prevent unjustified rate hikes beginning in 2014.

In 2015, the rate review led to roughly $1.5 billion in savings for consumers. The funds announced for 2017 are unused grant funding totaling $25.5 million from prior years. Each year, the unused portion of rate review grant funds remains available to plan and implement new insurance market reforms and consumer protections under Part A of Title XXVII of the Public Health Service Act (PHS). The first round of grants applied for are making their way to 22 states and the District of Columbia and you can see how each state plans to spend its grant money on the CMS website, which tracks these figures.

Approximately $21.6 million is being awarded to assist State Departments of Insurance in preparing and executing insurance market reforms and consumer protections. The remaining funds will be used toward other related expenses dealing with planning or implementing market reforms that extend across the health care industry for promotion, travel, equipment, supplies and indirect costs.

The Consumer Assistance Program Grants (CAP Grants) help to ensure that state laws, regulations, and procedures follow federal requirements as they evolve. The Obamacare marketplace is complex and continues to change as new phases begin and adjustments are made. Keeping up with providing new resources, education and accurate information to growing numbers of consumers requires many critical decisions for U.S. states and territories. Nearly $60 million will provide new programs for consumer assistance through direct support in answering health insurance questions. The funds go to state agencies and allow them to collaborate with non-profit organizations for additional support in helping consumers enroll, file complaints or appeals, obtain tax credits, understand their rights and actions, track problems and enforce regulations.

Each state needs funds to research, document, and analyze consumer questions and concerns relating to the required 10 minimum essential benefits that make up a qualifying health plan under the ACA. They also need to respond to these inquiries through additional manpower and facilities. The Department of Insurance is responsible for training staff to identify, assess and report issues regarding preventive services, equal benefits for mental health disorders and substance abuse, appeals processes, and the reduction in overall health insurance costs overall.

State Departments of Insurance are a critical component in making sure that health insurance providers are producing affordable plans that contain reasonable limits, and that costs that are justified. Companies must be proven financially stable so consumers stay protected. State regulations must also match new federal laws while addressing any discrepancies that appear.

Grants help each State Department of Insurance with incurred costs in promoting consumer education and awareness through industry professionals, associations and organizations; developing educational materials; updating their websites; presenting to stakeholders; participating in conferences; and purchasing advertising.

The grant award period runs from October 31, 2016, through October 30, 2018. Each grant will be treated as a project with a budget period of two years. Applicants each receive the baseline amount of $476,998 but are allowed to take less. Based on state population and the number of health insurance providers, a certain portion of funds is designated as “workload.” The remaining funds are earmarked for specified market reforms.

Consumer protection, quality service, and affordable products are the goals of the Affordable Care Act, and grants are built into the process. Individual states are integrating with the nationwide system and making the improvements necessary for consumers to understand the law, the system, insurance coverage options, and how to get the very best plans and service from their marketplaces. If your state spends its grant money wisely, then more tools will become available to simplify how you buy health insurance and how you receive information on upcoming changes.

How Many People Would Lose Coverage if the ACA Gets Repealed?

The Affordable Care Act (ACA) has been integrated in stages for nearly seven years, with most of the policies in effect having been executed over the last three. Repealing and replacing it is a monumental task.

Republicans have already designed many alternatives in the last few years, but none of them made it past the Senate majority or President Obama. However, with the combination of a Republican Congress and President-elect Trump, the ACA’s days may be numbered.

Trump met with President Obama shortly after the election and made a statement regarding key provisions of the ACA that he now intends to keep. Preserving the policy that allows young adults to stay on a parent’s health insurance plan until age 26, and the ban on denying coverage to those with pre-existing conditions, means a full repeal has been set aside. But the Affordable Care Act will be completely transformed, and many people stand to lose their current health plans.

Total Uninsured

Prior Republican legislation indicates a two-year time frame to establish Trumpcare’s system of tax credits and health savings accounts (HSAs) for individuals, the modernization of Medicaid and the creation of a free-market enterprise for health insurance and pharmaceutical companies. These plans are designed to encourage competition and lower costs throughout the health care industry. Options for replacement should be offered by 2019.

In late 2015, the CBO estimated that about 22 million people would have lost health insurance after the end of 2017 if the GOP’s legislation HR 3762 had been enacted. These would have been people covered through Medicaid and the insurance marketplaces.

The Committee for a Responsible Federal Budget followed in 2016 with an estimate of almost 21 million people losing their insurance coverage. They believe Trump’s replacement plans would cover just 1 million of the 22 million individuals expected to sacrifice benefits under the ACA repeal.

The Rand Corporation shows that the combined effect of Trump’s proposals would leave 20.3 million uninsured. It’s clear that around 20 million people would lose their current health benefits under the law if the ACA gets repealed, and Trump does not appear to have an adequate explanation for how those affected would be covered under his version of national health care.

Medicaid Enrollees

Lower-income individuals would be more affected than others when the Medicaid expansion is repealed along with the ACA. It covers 15.7 million additional people with incomes below 138 percent of federal poverty level, a provision added in 2013. A Republican administration will focus on getting people off of Medicaid subsidies and into private plans with tax credits to help cover the premiums.

Trump wants to replace current funding for low-income individuals to each state using block grants or per-capita allotments to supplement their own programs. This transition will not likely happen until 2018 or 2019.

Marketplace Consumers

If the estimates overall are roughly 22 million, and 15.7 of them are subsidized by Medicaid, that leaves about 6.3 million marketplace enrollees without their current coverage once the exchanges get dismantled under Trumpcare. However, there are many unknown variables regarding the replacement plans and the success of tax cuts, credits and deductions applied to the purchase of health savings accounts. The details of changes to Medicare and Medicaid could have wide-ranging effects on estimates in either direction.

Avik Roy, president of the Foundation for Research on Equal Opportunity, along with several economists, came up with vastly different numbers based on three different but very specific proposals for repeal and replacement. The Patient CARE Act would only reduce coverage by 3 million people, A Better Way would reduce coverage by 2 million, and Roy’s own proposal claims to increase the number of insured by 9 million.

The particulars of Trumpcare can greatly change the outcome; we might end up somewhere in between. For the 20 million or more Americans who count on the ACA for coverage, their future depends on those particulars.

Reaching Millennials for ACA Enrollment

As open enrollment for 2017 Obamacare coverage begins, the Centers for Medicare and Medicaid Services (CMS) is starting a new initiative to reach millennials who qualify for tax credits, but are not using them. The Affordable Care Act did a great deal to make health insurance available to everyone, especially for millennials. The rates for uninsured young adults have dropped considerably since 2010, but the CMS says that millions more millennials are still not taking advantage of the program.

The CMS estimates that around 90 percent of young adults with qualifying incomes would also qualify for tax incentives that would make health insurance more affordable. The problem is that most young adults have no idea they qualify for these incentives. As open enrollment starts, the CMS is working with the White House to spread the word and educate younger generations – specifically those aged 18 to 34 – on Obamacare.

Going Where Millennials Go

The CMS understands that millennials are not likely to get this new information from, so the government is going where millennials are known to go. Many popular social media platforms, such as gamer site, will start hosting ads from the CMS outlining the benefits of enrollment in various health care plans offered by the Affordable Care Act.

The CMS will also be touting its new mobile interface, which will make comparing plans during the enrollment process much easier this year. It’s estimated that 20 percent of all young adults access the internet exclusively through their smartphones. Previous limitations on the ACA mobile app explain why so many millennials did not bother to register. With the new and improved app, the CMS is confident that more millennials will be able to check out the available plans and enroll.

A Massive Effort to Encourage Millennial Response

The CMS and White House are not campaigning for millennial enrollment on their own. The list of associated organizations helping in this effort to reach young adults includes:

  • American Hospital Association
  • Autism Speaks
  • The Truth Initiative
  • Planned Parenthood Federation of America
  • United Methodist Church
  • American Medical Student Association
  • March of Dimes

Dozens of groups are getting involved, and they will all be reaching out to millennials on social media using the hashtag #HealthyAdulting. Since many of these organizations are popular with the young adult demographic, the CMS expects to be able to reach millions of millennials quickly.

Government Support

Government agencies, such as the Department of Defense, Medicaid and the Children’s Health Insurance Program (CHIP) will also be distributing helpful information to millennials while encouraging young enrollees to explore their health care options when signing up for various military programs. In addition, the IRS will be developing a list of millennials who could benefit from this information by pulling out the names of young adults who paid the federal tax penalty for not having health coverage.

The CMS is intent on getting as many millennials as possible to sign up for insurance and protect their health. With this combined initiative, the CMS anticipates that it can reach as many as 5 million young adults before the open enrollment period ends on January 31.

Millions of Americans Need to Plan to Shop for Health Insurance this Open Enrollment Period

Marketplace enrollees may discover that their health coverage for 2017 differs dramatically from their 2016 plans. An estimated 2 million people who enroll using state and federal health insurance exchange sites will be forced to choose new coverage for next year. This is due to several major and minor insurance providers dropping out of the exchanges. United Healthcare, Humana and Aetna — three major national insurers — have already announced that they will not be participating in many or all of the markets where they currently offer coverage. In some states, smaller issuers have also dropped out, citing financial loss as the primary motivator.

Under the Affordable Care Act, consumers have the option to let their health plans “auto renew,” which essentially means that a person’s health insurance coverage will simply renew each year unless changes are made. During open enrollment each year, enrollees can also make changes or sign up for a new health plan altogether. Unfortunately, many consumers allow their plans to renew automatically.

Auto renewal can be a risky option since health plans change from year to year. In a competitive marketplace, health insurers offer newer plans with better features. Consumers who shop for coverage are more likely to find a better deal in terms of plan benefits and monthly premiums. For 2017, shopping for coverage is not only beneficial but essential for some consumers. With several major providers bowing out of the marketplaces, enrollees could find themselves forced into different plans, a situation known as “health plan mapping.”

Plan mapping occurs when a carrier moves an enrollee to a similar plan because the person’s current plan has been discontinued. It’s not a new practice, but it has become more common thanks to the competitive nature of a post-ACA insurance market. When carriers innovate or update their plans from year to year, they simply map enrollees to a similar policy if those enrollees allow their plans to auto renew.

The practice itself isn’t necessarily a bad thing, but for some consumers, plan mapping may mean a higher monthly premium, a narrower network or different health care options. Next year, the marketplace may look very different due to the absence of major insurers like Aetna and United Healthcare. People who have plans with insurers that have cut ties with the exchange sites will be forced to choose a new policy — or have it chosen for them.

Under the Notice of Benefit and Payment Parameters for 2017 issued by the Department of Health and Human Services (HHS), the exchange sites will determine health insurance coverage for anyone whose plan no longer exists provided that the enrollee doesn’t come back to the site to select a plan. In other words, if you have a plan with one of the carriers that isn’t participating in the exchanges and you don’t choose a new plan during open enrollment, then the exchange site will choose one for you.

The wording used by the HHS makes it clear that the exchange site will do its best to find similar health plans, but this is no guarantee that a consumer will have comparable coverage — or a comparable monthly premium. In some instances, enrollees may be mapped onto different carriers entirely, which could impact network and availability. Prior to 2017, mapping consumers onto a different carrier was not allowed. This has changed for next year. estimates that about 2 million exchange enrollees will be affected by insurer dropouts in 2017, most of whom have plans with United Healthcare and Aetna. Open enrollment begins Nov. 1 and runs through Jan. 31, 2017. Shopping for a new plan can result in lower premiums or better features. Consumers are encouraged to check the status of their health plans and browse for new coverage next year.


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