The Final Countdown for 2017 Coverage Underway in the Shadows of Affordable Care Act Repeal

By Rachel Schwab and Sandy Ahn

Just four days away, December 19th is the last chance for consumers to enroll in an Affordable Care Act marketplace plan that starts January 1, 2017. With an incoming Congress and President-Elect promising to repeal the health care law, consumers may have questions about what will happen to their coverage or why they should bother to enroll. Before the sun sets on this year’s open enrollment season, we’ve answered a couple of common consumer questions:

1) If I sign up for coverage now, will I be able to stay enrolled if the ACA is repealed?

Yes, for coverage through 2017. Plans offered for 2017 have already been approved by federal and state regulators and the federal and state approval process requires the plans be offered until the end of the calendar year. If there are extraordinary circumstances that result in a state allowing an insurer to discontinue a plan mid-year, there are protections in place to provide opportunities for enrollment into another plan. You have a right to purchase health insurance for 2017 now during open enrollment. You must sign up for 2017 coverage by December 19, 2016 to have your coverage start on January 1. If you miss the December 19th deadline, you still have until January 31, 2017 to sign up although your coverage won’t start until February 1 or March 1, depending on when you signed up in January.

2) Since some of the Affordable Care Act replacement proposals include a continuous coverage requirement, should I sign up now to make sure I’m not locked out of coverage?

The short answer is yes. The requirement to have health insurance or face a monetary penalty is currently the law of the land. You should sign up for 2017 coverage so you’ll have health insurance when you need it and so you won’t face a tax penalty for being uninsured. The penalty of not having coverage in 2017 is the greater of:

  • $695 for each adult and $347.50 for each child, up to $2,085 per family, OR
  • 2.5% of family income above the tax filing threshold, capped at the national average of the lowest cost bronze plan available through the marketplace.

Some of the proposed ACA replacement plans require that people maintain continuous coverage (for periods of 12, 18, or an unspecified number of months) or else be subject to higher premiums. A number of these plans propose a one-time open enrollment period during which consumers could purchase coverage without being penalized for not having continuous coverage. However, given the uncertainty surrounding a replacement plan, and what it will entail, there is no guarantee that this one-time open enrollment period will be included in a final bill replacing the ACA. Enrolling now during open enrollment will protect you in case there is a continuous coverage requirement in any replacement plan.

The future of the ACA is unclear. If policymakers move forward with plans to repeal the ACA, as many as 30 million people could lose their coverage, but it is unlikely that will happen quickly. In the meantime, consumers can protect themselves and their families by purchasing marketplace coverage for 2017. Ultimately, health insurance is a critical protection against the financial and health risks of becoming sick or becoming injured. As questions like this continue to pop up, CHIR will do our best to arm folks with the information and resources to make smart decisions about their health insurance.

This blog has been updated to reflect the extended deadline of December 19, 2016 to get coverage starting January 1, 2017.

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