We’re officially halfway through the Affordable Care Act’s 2017 open enrollment period. If this news comes as a surprise to you, you should know—that was the point.
In August, the Trump administration announced plans to shorten this year’s enrollment period from 3 months to 6 weeks and slash its outreach and advertising budget by 90 percent. This is an effort to engineer failure within the federal- and state-run marketplaces established through Obama’s landmark health law. Policy experts and elected officials across the country have denounced these moves as an unabashed effort to undermine the ACA’s success.
Cutting ACA Advertising by 90% is evidence-based policy … if policy goal is sabotage. https://t.co/5Y0Yt7CB0T
— Daniel Polsky (@healthecon_dan) September 1, 2017
This is a sign that the Administration plans to depress enrollment.
Latino community is 1 of the most important to reach (see next tweet). https://t.co/E4p5u8Cy5y
— Andy Slavitt (@ASlavitt) August 10, 2017
Despite Trump’s attempts at sabotage, the ACA has experienced its best enrollment period on record so far. Consumer advocates, public health departments, faith-based groups and more have used the federal government’s inaction to fuel coordinated, grassroots efforts to inform folks of their options and assist them in finding health insurance.
Also making national news is the fact that a record number of health insurance marketplaces are offering low-cost insurance plans, with premiums ranging from $0 to $75. Analysis from the Kaiser Family Foundation as well as the Center for American Progress confirm that low- to middle-income consumers now have a better chance than ever to find a truly low cost insurance plan.
This is largely the result of a separate, backfired attempt to damage the Affordable Care Act. In early October, the Trump administration ended payments for cost sharing reductions (CSRs), a type of subsidy designed to help individuals and families with income up to 250 percent of the federal poverty level manage out-of-pocket costs.
Until they were discontinued, CSRs worked like this: insurance carriers would offer a family or individual a discounted level of cost sharing on their insurance plan up front with the understanding that the federal government would pay that insurance carrier the difference. By abruptly cancelling CSR payments, consumer prices would rise drastically and insurance carriers would be thrown into a panic, creating widespread instability in the health insurance market.
Though premiums prices did rise for some consumers, a more surprising change took place — premium tax credits, a second kind of subsidy that helps low- and middle-income families afford their monthly premium, increased too. This is because the size of the premium tax credit is pegged to the cost of the second-lowest-cost silver plan (called a “benchmark plan”) in a marketplace. When insurance carriers increased the cost of their benchmark plans in response to CSR repeal, the size of the premium tax credit went up too.
Because of this increase in premium tax credits, the Center for American Progress finds that a 27-year-old single adult making $25,000 can purchase a plan with monthly premiums costing less than $20 in over half of U.S. counties. Prices are similarly low in some Washington State counties; that same 27-year-old could purchase a plan in Grays Harbor County for $38 or King County for $80, though a plan in Spokane County would cost at least $119.
Such variation in price may seem arbitrary, but the federal government determines each individuals’ premium tax credit eligibility with an algorithm that looks at five key factors, the first of which is household income. The algorithm also takes into account age, geography, household size, and smoking status, though the methodology behind how each factor is weighed is more complicated.
In summary, folks can expect to see two main trends for the remainder of the ACA enrollment period.
- Consumers who do not qualify for federal subsidies may see a significant increase in premium costs or may not see much of a difference in price from last year to this year, and
- Consumers who do qualify for federal subsidies are protected from premium increases and may find their insurance options on Washington’s exchange to be significantly more affordable than last year.
In either case, it’s a good idea to get on Healthplanfinder before December 15 to cost compare and find your most affordable option — and don’t forget to factor in the deductible, which includes the majority of your out-of-pocket costs.
People who don’t qualify for federal subsidies may benefit additionally from checking with an insurance broker like Stride Health to see if they can find a cheaper plan outside of the exchange.
Here are some resources for assistance in navigating the maze that is our health insurance system. Happy searching!
WithinReach Family Health Hotline: 1-800-322-2588
WashingTeen Help Hotline: 1-800-322-2588
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