Open enrollment has started for the 1/1/2018 policy year and anyone faced with a purchase decision is surely confused. On the off chance that any of those prospective healthcare exchange customers are following this blog I thought I would take this opportunity at the start of the shortened open enrollment period to clarify the rules:
- Healthcare open enrollment is an annual event.
- This year it begins 11/1/17 and ends 12/15/2017 for coverage effective 1/1/2018.
- This is the only time which any American can purchase coverage unless there is a Qualifying Life Event (QLE).
The Affordable Care Act (ACA) has not been modified as of yet and if an individual does not have coverage for every family member a penalty would still apply. Effective for 2017 tax returns, the federal government requires that every filer indicate whether they have coverage or an exemption. Although they have not been vigilant in collecting penalties in previous years, the IRS has announced that they will begin enforcement. They have said it before and ended up being passive – but who knows?
Individuals earning less than 400% of the federal poverty level are entitled to premium subsidies, to make coverage more affordable, based upon the Second Lowest Cost Silver Plan (SLCSP) on the individual’s applicable exchange. And if the family earns less than 250% of the federal poverty level, the INSURANCE CARRIER is required to lower the out-of-pocket costs. Note that the president’s executive order cut off funding for these subsidies, but not the insurance companies’ obligation to provide them. This will certainly be confusing to prospective purchasers. And the threat has been estimated to add an average of 34% to premiums.
To stir the pot, President Trump tweeted on Wednesday a request to House Republicans to repeal the ACA individual mandate as a part of the tax overhaul. Just what was needed – even more confusion. I don’t see how this would happen since a “light” version of repeal already crashed and burned. In view of the confusion, I also don’t think the federal government can hope to enforce this penalty. I thought Ringling Brothers shut down their operations. I think they may have resurfaced in the healthcare system.