Attention: if you have a low enough income to get premium subsidies from the ACA, you will still get them this year and next year. If you have a low enough income to get cost sharing reductions (that is, a lower deductible and lower copays) you will still get them.
Open Enrollment for 2018 starts November 1st. Attention: for most states, it ends December 15th, not January 30th as it did last year. Don’t delay.
Some states (California, Colorado, Connecticut, DC, Massachusetts, Minnesota, New York, Rhode Island, Washington) have extended the enrollment period a little or a lot. It’s still better to enroll early and get it over with.
Everyone should shop around. Don’t just re-enroll with last year’s plan. If you get subsidies but you don’t get cost sharing, a Silver plan will probably not be a good choice for you. Check!
Not looking forward to this. I’m so annoyed that my husband and I don’t count as a group anymore, even though we are both professional engineers. We have to buy on the individual market. This may be the year our monthly premium exceeds our mortgage payment.
Romani, I can help you out with any questions you have.
The most important thing for you is to get signed up in time. You’re in Michigan. You must sign up by December 15th.
If you are getting cost sharing subsidies and are under 200% of the federal poverty line, get Silver.
If you are getting subsidies and over 200% of the federal poverty line, you’re in luck! Michigan has told insurers to raise prices for Silver plans only, to make up for the CSRs. That’s good news for you. Your subsidies will be much bigger. Gold will be a big bargain for you. (Bronze would be almost free, probably, but in your particular situation I think Gold would be better.)
If you aren’t getting subsidies, Do Not Get Silver.
There is very little shopping around here (Chicago area). One provider. BCBS.
Is the penalty for not having a qualified plan going to be enforced? Seriously considering a short term plan, as @MaineLonghorn mentioned, we are expecting 2018’s premiums for two 50-something adults, least expensive plans, to exceed our mortgage payment.
Midwest67, by shopping around I meant not just checking different insurers (which you can’t do because you only have HCSC) but also checking metal levels. Do not get Silver! Illinois instructed insurers to increase premiums on Silver only, to pay the CSRs. It looks like the mandate penalty will be enforced.
MaineLonghorn and Midwest67, pay attention to what happens with association plans and short term plans. When the new regulations come out, they might be right for you. It looks like HHS will make it legal to sell short-term plans that last a year. But, please, pay attention to scams and fraud and read the fine print.
Association health plans are not regulated by states. For example, whereas regular health insurance plans are required to have a certain amount of capitalization so they will have enough money to pay claims, association health plans do not face those requirements. In the past, some association plans have run out of money, and some have been scams that took policyholders’ money and scampered.
Short term health plans, because they are sold to healthy people, are hugely profitable to the sellers. I’m told brokers get a 15-20% commission on them. Read the fine print to make sure what you need to be covered will be covered. MaineLonghorn, I’m sure you’re cognizant that someone might need mental health coverage suddenly and unexpectedly, for example. Also check the drug formularies.
Midwest67, by shopping around I meant not just checking different insurers (which you can’t do because you only have HCSC) but also checking metal levels. Do not get Silver! Illinois instructed insurers to increase premiums on Silver only, to pay the CSRs.
I remember when the bar association had plans for attorneys who weren’t insured by big firms. I wonder if those types of association plans are coming back now. I think the ACA didn’t allow those types of plans (groups or associations plans, like the Writer’s Guild for example).
In any event, Anthem is moving out of my area so my choices will be very limited for next year.
@“Cardinal Fang” I have insurance through the U so I’m all set. It’s my friends I’m worried about. I’m probably going to come back for questions when the new enrollment period hits.
A lot of my friends turned 26 this year so this is new territory for many. Every one will qualify for a subsidy and as far as I know, I haven’t heard of anyone pulling out of our market. I’m hoping people will just be able to re-enroll in their same or similar Silver plans.
As of now, nothing is changing with respect to association plans and short term plans. The White House directed the agencies to make new regulations. Nothing changes until after the regulations are announced. Probably nothing changes until the notice and comment period takes place.
Rom, the enrollment period is so short that I advise your friends to get their questions answered as soon as possible, starting right now. Some states (like my California) already have the plans up on the website for window shopping.
Rom, if your friends make more than 200% of the federal poverty level (about $24,120), they should probably not get Silver. Gold will almost certainly be better for them at almost the same price! If they make less than $24,120, they should go for Silver.
I know. It’s complicated. This CSR nonsense made what was already complicated much more complicated.
Could you explain any immediate impact of the executive order and the CSR announcement? Is it just noise and optics at this point vs. anything tangible?
The immediate impact of the executive order: noise.
The immediate impact of not paying the CSRs: considerable. In most states, most consumers are better off or at least no worse off because of the feds not paying the CSRs.
It depends on your state. In most states, people over 200% of the federal poverty level should not buy Silver insurance, but as I said, it depends on your state and your situation.
Some states allowed or required insurers to assume that CSRs would not be paid.
Some states allowed or required insurers to assume that CSRs would be paid. In most of those states, insurers are getting to refile their rates (higher, of course) to account for the fact that CSRs are now not going to be paid.
States made various choices about how insurers should account for CSRs not being paid. It depends on your state. Most states allowed/will allow insurers to raise premium prices on Silver plans only. Some states allowed insurers to raise premium prices on Silver plans on the exchange only. A few states made insurers raise prices on all plans.
I’ll be happy to answer questions about individual states. It’s complicated.
Oh, and not paying CSRs is going to cost the federal government billions of dollars. It costs more not to pay CSRs than to pay CSRs, because premiums go up, and then premium subsidies go up, and then the government has to pay the larger premium subsidies.
@“Cardinal Fang” Thank you. You’re providing a great service to CC members. This whole insurance business is hard to understand.
Anthem Blue Cross has pulled out of the individual market in my community leaving Blue Shield as the only option. Unfortunately Blue Shield has a very small network of in network doctors and doesn’t include the largest medical group in our community. It is going to have a huge impact on finding a Dr and getting care in a timely manor. They have absolutely no GI specialists in network in our city and only one urologist who I know only sees patients in our city one day a week. To have a colonoscopy one will have to travel to a city 45 minutes away. That alone has pushed me to finally make an appointment for a colonoscopy before the year is up. I hope I can get an appointment as I’m sure others are going to try to do the same.
One change I think we will make is that I will look into buying my last dependent daughter insurance in the area where she lives. Her part of Ca at least has choices.
My wife just enrolled in Medicare today (effective Dec 1). I still have a few more months in the private ACA market. My concern has always been focused on the lowest income folks in non-Medicaid expansion states who have been left with no healthcare coverage and no subsidies. Now it looks like people just above the subsidy limit are gettting squeezed just as badly, with premiums that are simply not affordable. Many of us in the middle are getting a very good deal - heavily subsidized health insurance. I don’t know what the numbers are now in each group, but it feels out of balance.