Affordable Care Act Enrollment Now Underway

Open enrollment for people shopping for 2018 health insurance through the Obamacare exchanges begins Wednesday.

For most consumers, it promises to be an even more frustrating event than usual.

Fewer choices in the exchange marketplace and recent cutbacks from the Trump administration, including ending important reimbursements and slashing consumer support, make for an uncertain market and confused customers.

People are fending for themselves at a time when they seem more perplexed than ever. Almost 76 percent of Americans don't know when open enrollment is, according to a new survey from Policygenius. And 18 percent didn't realize the Affordable Care Act was still the law.

In a normal year you would have gotten a letter from your current insurer by now informing you of any changes in your existing plan and what premiums you can expect to pay for 2018. Patients often use these letters to determine if they'll keep their current coverage and to help them compare it with any alternatives available.

But many insurers have held off on sending renewal notices because of the uncertainty over premium prices. In fact, many insurers are only just now sending out these notices.

Under the Affordable Care Act, insurers must provide subsidies to low-income patients to help pay for out-of-pocket health-care costs such as deductibles and co-pays. The federal government then reimburses insurers for those subsidies. Now that the federal government has announced it will no longer make these reimbursements, most insurers have raised premiums to offset the costs of unreimbursed cost-sharing payments.

Legislative and legal challenges are expected to continue, but probably not in time to affect the 2018 enrollment period.

In the 39 states in which the federal government runs the exchange, open enrollment runs from November 1 until December 15 for coverage starting January 2018. 

Earlier in the year, there was speculation that the Trump administration would look the other way if the IRS didn't enforce penalties for people who don't get health insurance coverage. This individual mandate is one of the most debated aspects of the ACA. But the IRS announced earlier this month that it will require taxpayers to disclose whether they have purchased health insurance.