Several changes have been implemented by executive order that will impact this Open Enrollment Period for the Affordable Care Act Marketplace in SC in 2018. Among them are:
The open enrollment period has been cut in half, from ninety to forty-five days. The abbreviated period is from November 1 through December 15, 2017.
Advertising for open enrollment has been reduced by 90%, from $100 million to $10 million nationwide.
Grants for in-person enrollment assistance have been cut nationwide. SC’s statewide navigator grantee Palmetto Project is receiving 54% less funding, and the funds of another grantee The Beaufort County Black Chamber of Commerce were reduced 90%. Palmetto Project has decreased the number of navigators from 60 to 30, and will only have dedicated navigators in 17 counties this year. All 46 counties were covered in years past.
The Trump Administration has ended payment for the cost-sharing reductions (CSRs) to insurance companies. This funding subsidizes lower out-of-pocket costs for low-income Americans in the Marketplace. Blue Cross Blue Shield of SC has increased Marketplace premiums an average of 31% to account for this decrease in funding.
Premium discounts/subsidies are still available and will be more generous this year due to the administration ending payment of the CSRs. Because consumer subsidies are based on the price of the second-lowest silver plan in a market, premium increases have led to corresponding subsidy increases for consumers with incomes between 100 and 400% of the federal poverty level ($12,060 to $48,240 for individuals and $24,600 to $98,400 for families of four).
Many uninsured South Carolinians will be eligible for zero-premium bronze plans on the Marketplace. Gold plans will also be more affordable than in years past.
The nine of 10 South Carolinians who received subsidies averaging $422 a month last year will not be significantly impacted by the premium increase.
The one in ten South Carolinians who purchased ACA Marketplace plans without a subsidy would see their premiums increase by 39% if they remain on the Marketplace. There are off-Marketplace plans that would have lower premium increases around 13%.
The Healthcare.gov call center and website will be closed the evening of November 1, every Sunday from midnight to noon during the enrollment period except December 10, and it will close during the Thanksgiving holiday.
Consumers who have auto re-enrolled in coverage for two years will not be permitted to auto re-enroll this year.
Consumers owing premiums for coverage last year will have to pay a one-month lapse premium payment in addition to the first month’s premium for their 2018 plan by December 31 to effectuate coverage.
But several things remain the same:
The Affordable Care Act is still the law of the land, along with the individual mandate penalties for not having health insurance coverage ($695 per individual or 2.5% of your income, whichever is greater). While some question whether the IRS will enforce the penalties, the agency stated this week they will reject returns that lack the health insurance disclosure.
It is in every consumer’s best interest to actively re-enroll or enroll for the first time by exploring the coverage plan options for what is best for their finances and family health care needs.
Free assistance is available through navigators, insurance brokers, as well as certified application counselors (CACs) in health centers across the state.
For those seeking coverage who would like face-to-face help from a certified navigator or assistant, please visit www.signupSC.com or call 1-888-998-4646 to schedule a personal appointment with a professional.
For more information and to enroll in coverage beginning November 1, 2017 visit www.healthcare.gov.
For social media infographics and other promotional materials in our SCHA Open Enrollment toolkit, click here.