Health Care MarketplaceNews & Research

ACA enrollment figures boosted by Young Invincibles

With the third Open Enrollment Period (OEP) having come to an end, things have gone very smoothly. As of Jan. 23, 2016, a total of 11.6 million Americans had either signed up for Affordable Care Act (ACA)-compliant health insurance plans or renewed their coverage. This OEP also marked an enrollment experience relatively free of problems.

The 2016 OEP is also notable for having attracted large numbers of, younger, healthier consumers. These millennials (18-34 years old) are favored by the large insurance carriers that comprise about half of all Obamacare policies. With fewer older, sicker enrollees, plan premiums are typically reduced for all members. The increases in younger, healthier consumers should also enable the healthcare law to succeed in years to come.

An upswing ends 2016 enrollment

With the OEP’s closing, the only way to still obtain coverage is through a Special Enrollment Period (SEP), offered by the government. Or, you may be offered a personal SEP if specific life changes, known as Qualifying Life Events (QLEs) (e.g. marriage, childbirth, loss of coverage), occur. Those without ACA-compliant coverage may face tax penalties (the individual mandate); the 2016 amounts are substantially higher last year’s, although hardship exemptions may be available. If found liable, consumers will have to pay the greater of:

  • $695 per adult and $347.50 per child, for a maximum of $2,085 per family, compared to 2015’s $325 and $162.50
  • 2.5 percent of your income above the tax filing threshold, compared to 2015’s 2 percent

While these penalties are a major financial burden, they have persuaded Americans to purchase health coverage. By the OEP’s 12th week (Jan. 17-26, 2016), the Centers for Medicare and Medicaid Services (CMS), the agency overseeing the ACA, calculated an estimated 8.9 million sign-ups in the 38 states utilizing the government’s HealthCare.gov platform. And with state-run exchanges (and the District of Columbia) included, the current tally of plan sign-ups and renewals increases to 11.6 million.

Some states (and the District of Columbia) with their own exchanges are offering enrollment extensions. For instance, both Covered California and The Maryland Health Connection have extended their deadlines until Feb. 6. While extensions were provided in past years, due to technical issues and other issues, the OEP saw few problems. In fact, the Obama administration reported that there will be no official SEP in 2016.

Millennials smoothing out the risk pool

Of these sign-ups, the CMS found that 2.1 million 18-34-year-old consumers – also known as Young Invincibles (YIs) — had purchased coverage by Dec. 15, 2015. For this time in 2015, 1.1 million in this age range had purchased coverage. This offers evidence that the ACA’s continued efforts to draw enough YIs to balance out the risk pool is succeeding. Insurance carriers feel that this age group is generally healthier than older members, thereby increasing profits and decreasing medical costs for the coming year.

But these lower costs and happier carriers are expected to make Obamacare financially stronger in years to come. “Having people of good health participating in the marketplaces will contribute to the long-term financial stability of those marketplaces,” stated White House Press Secretary Josh Earnest. “That’s why that was a focus of our efforts, and the early indications are that those efforts were successful.”

Missed Open Enrollment? Here Are Two Great Options

Open Enrollment for 2016 has ended. However, if you missed the deadline you still have options:

Get a cheaper alternative to Obamacare with Short-Term Insurance.

What is Short-Term Health Insurance? Short-term insurance is great if you:

  • Need coverage and Open Enrollment has ended
  • Need coverage immediately (coverage can start the next day)
  • Don’t have a pre-existing condition
  • Don’t have a qualifying life event
  • Need a plan for less than 12 months
  • Acknowledge that you understand that short-term plans do not comply with the individual mandate under the law

Plans can start as low as $50 per month.

View Short-Term Plans

 

If you had a “qualifying life event” you can still enroll in Obamacare/ACA insurance and receive subsidy discounts.

What does this mean? If you had a “Qualifying Life Event” you are allowed to enroll in health insurance outside of the Open Enrollment period. If you experienced one of these events in the last 60 days, you can enroll in a plan up until the 60th day after the event occurred:

  • You got married or divorced
  • You had a child or adopted a child
  • You turned 26 yrs old and will lose coverage on your parent’s plan
  • You lost health coverage from your job
  • You moved locations and your insurance is no longer offered
  • You had a change in income (and are now eligible for a bigger or smaller subsidy)
  • View more Qualifying Life Events
View Obamacare Plans

 

 

2017 Open Enrollment Deadlines

The open enrollment period for Obamacare health insurance in 2018 starts on November 1, 2017 and ends on December 15, 2017.
Critical deadlines are:

  • November 1, 2017: Open Enrollment begins. Apply for new coverage. Coverage will begin on January 1, 2018.
  • December 15, 2017: Deadline to enroll in a new health insurance plan for the 2018 calendar year. Coverage will begin on January 1, 2018.

If you miss this window you cannot enroll until the Marketplace re-opens in November 2018 unless you have a special “life event” such as having a baby, getting married or losing your coverage through your employer. This is designed to prevent people from taking advantage of the system by enrolling and dropping insurance multiple times a year when they only get sick.

If you don’t enroll in an Obamacare plan in 2017, you may be fined 2.5% of your income or $695 per adult, whichever is higher.

Individuals and children who earn less than 100% ($24,300 for a family of 4 in 2017) or 133% ($32,300 for a family of 4 in 2017) of the federal poverty line, depending on the state that they live in, can enroll in Medicaid or the Children’s Health Insurance Program (CHIP) at any time. There is no enrollment period for these programs, but there are income restrictions and other qualifiers.

Coverage start dates

If you don’t enroll in a health insurance plan during the 2018 open enrollment period, you won’t be able to enroll again during the 2018 calendar year unless you experience a special event that would start a special enrollment period. Examples of these “special events” or qualified life events as they are also called, are: you move to a new state and your coverage isn’t offered there, you lose your plan through your job and need to buy your own insurance, you were previously on your parent’s health insurance policy but are now too old to be on it (26 years old or older), you got married or divorced or you had a baby.

Visit here for information on the past 2017 open enrollment deadlines.

Avoid Serious Risks And Enroll Before The January 31 Deadline

The Department of Health and Human Services (HHS) has announced from Nov. 1, 2015 through Jan. 20, 2016, an estimated 8.8 million people had enrolled in Obamacare/ACA insurance in the 38 states that rely on the federal exchange and another 2.7 million that use state-run exchanges (and the District of Columbia). Open Enrollment ends on January 31 and if Americans miss this deadline there are stronger penalties and risks than in previous years.

4 Risks To Not Enrolling By January 31:

Tax penalties – By not enrolling by 11:59 p.m. on Jan. 31, you could face IRS-imposed tax penalties. Some consumers may avoid these if they qualify for hardship exemptions. But if found liable, you’ll pay the greater of:

  • $695 per adult and $347.50 per child, for a maximum of $2,085 per family; the 2015 penalty was $325 per adult and $162.50 per child
  • 5 percent of your income above the tax filing threshold; the 2015 penalty was 2 percent

Read more here: Obamacare tax penalty.

Inability to purchase coverage – Not enrolling may prevent you from being insured later on. You may be able to enroll outside of the OEP, during a Special Enrollment Period (SEP), if you experience special life changes, known as Qualifying Life Events (QLEs); e.g., childbirth, loss of coverage, relocation. However the government has recently announced new restrictions that will make it more difficult to enroll for an SEP.

Short-term health insurance – Consumers may have to turn to short-term (or temporary) policies, which are meant for shorter periods (1-12 months). But they only cover emergencies, whereas traditional plans provide preventive care, physicals and immunizations. They do not meet the ACA’s benefit standards, so you could still face tax penalties. Short-term plans are not eligible for government subsidies. Pre-existing conditions are not covered, and you may be liable for coverage gaps if you switch to a traditional plan.

Out of pocket – Paying all medical expenses yourself can be very expensive. In 2014, uninsured low- and middle-income, nonelderly adults were twice as likely as those who gained coverage or had coverage to have problems paying medical bills. They were more likely to use up savings, have problems paying for necessities, borrow money or have medical bills sent to collection.

Apply for health insurance today Start Here