Obamacare open enrollment dates and more:
- Our updated guide to Obamacare’s open enrollment
- Dozens of enrollment FAQs
- Enrollment tools, including a premium subsidy calculator
- An overview of each state’s exchange including updates on rate increases and carrier participation
What you need to know about open enrollment for 2020 coverage:
- Early indications are that rate increases will be modest for 2020
- Your plan will take effect January 1, 2019. If you want coverage between now and then, consider a short-term plan.
- Premium subsidies will continue to keep pace with the cost of the benchmark plan in each area.
- If you’re eligible for cost-sharing reductions, you’ll continue to receive them.
- In most states, there won’t be a penalty for being uninsured in 2020, but you still need coverage!
- Don’t expect widespread promotion of open enrollment from the Trump Administration.
The Affordable Care Act, also known as Obamacare, is still making headlines and causing confusion. But after two years of carriers exiting markets and fairly steep rate increases, we saw an influx of carriers joining the exchanges for 2019 – or rejoining, after a previous exit – and average rate increases that were substantially smaller than they were for 2017 and 2018. Although rate proposals for 2020 are only available in a handful of states thus far, they’re shaping up to be fairly modest, with an average proposed increase of less than 4 percent.
Open enrollment for 2020 coverage will run from November 1, 2019 to December 15, 2019 in most states (California and Colorado have permanently extended their open enrollment periods, and other state-run exchanges may extend their 2020 enrollment deadlines).
For most enrollees, the enrollment process will be very similar to how it worked for 2019. But Nevada is switching to their own enrollment platform (instead of HealthCare.gov) in time for the open enrollment period that starts November 1, 2019.
Here’s what to keep in mind as we head towards open enrollment:
All plans will take effect on January 1, 2020
When you purchase coverage during open enrollment, the effective date will be January 1, 2020. If you already have an individual-market plan and you’re picking a different one during open enrollment, your current plan will end on December 31 (assuming you continue to pay all of your premiums when they’re due) and the new plan will take effect seamlessly the following day.
But if you’re uninsured, it’s important to understand that you could have to wait up to two months from the time you enroll until the time your new plan takes effect. If you’re in that situation and fairly healthy, a short-term plan can bridge the gap for you. Short-term plans are available in most states, and the coverage can take effect as soon as the day after you purchase your plan. So if you’re enrolling in an ACA-compliant plan on November 1, you can also enroll in a short-term plan on the same day. Your short-term plan will cover you until the end of the year, providing peace of mind just in case you end up with an unexpected emergency before the end of the year (you can click on your state on this map to see how short-term plans are regulated and which options are available to you).
Premium subsidies will keep pace with the cost of benchmark plans
The ACA’s premium subsidies are designed to increase to keep pace with the cost of the benchmark plan in each area. As premiums grow, so do premium subsidies. But starting in 2018, premium subsidies became disproportionately large in many areas, due to the way states and insurers handled the loss of federal funding for cost-sharing reductions (CSR).
That continued to be the case in 2019, and the disproportionately large subsidies became available in more places (for example, Vermont and North Dakota didn’t allow insurers to add the cost of CSR to premiums for 2018, but began allowing it for 2019, resulting in much larger premium subsidies. Colorado and Delaware required insurers to spread the cost of CSR across premiums for all plans in 2018, but allowed the cost to be added only to silver plans for 2019, resulting in larger premium subsidies).
This “silver loading” will continue to be widespread in 2020, so don’t pass up the opportunity to get a subsidy! [HHS has indicated that they’re considering the possibility of new federal rules, possibly starting as soon as 2021, regarding how the cost of CSR is handled by insurers. But nothing is changing about silver loading for 2020.] Even if you’ve checked your eligibility before, make sure you do so again for 2020. As the poverty level rises each year, the income cap on subsidy eligibility also rises; it will reach $103,000 for a family of four in 2020 (the prior year’s poverty level numbers are used, so 2019 numbers are used to calculate 2020 subsidy amounts).
The short story: Shop around during open enrollment. You might find that subsidies are larger in your area than they were in the past, but you could find that they’re smaller. And in order to avoid an increase in the portion of the premium that you pay, you might find that you need to switch to a different plan for 2020.
If you’re eligible for cost-sharing reductions, you’ll continue to receive them
The federal government still isn’t funding cost-sharing reductions (CSR), but insurers and state regulators figured out a workaround (silver loading), and its use will be widespread for 2020. The details are explained here, but the short story is that the cost of CSR is being added to silver plan premiums in most states, and the CSR benefits themselves continue to be available in every state.
No penalty for being uninsured in 2020, but you still need coverage!
The ACA’s federal individual mandate penalty has been $0 since the start of 2019, and that will continue to be the case in 2020. People who are uninsured in 2019 and beyond will not face a penalty, unless they’re in a state that imposes its own individual mandate (note that Vermont will join that list as of 2020).
Going without coverage isn’t wise, though, regardless of whether there’s a penalty. And open enrollment only comes around once a year. So if you were to find yourself uninsured and in dire need of medical care in mid-2020, you’d have to wait until 2021 to have coverage.
It’s true that there are more loosely-regulated coverage options available now, thanks to the expansion of short-term plans and association health plans. And there is no longer a direct penalty for relying on those types of coverage. But they all have drawbacks, so read the fine print carefully if you’re considering them.
Don’t expect the federal government to heavily promote open enrollment
In the fall of 2017, just before open enrollment for 2018 coverage, the Trump Administration announced drastic funding cuts for exchange marketing and enrollment assistance. And in 2018, the Administration again slashed funding for Navigator programs, down to just $10 million (it had already been reduced to $36 million in 2017). The lower funding levels are likely to remain in place for the duration of the Trump Administration, and the Administration is likely to once again promote Medicare open enrollment but not individual market open enrollment.
But state-based exchanges and consumers advocates will continue to conduct outreach, and enrollment assistance will continue to be available throughout the country.
Of course, we know plan buyers have plenty of questions and concerns. The good news is that we’re again providing answers about enrollment in our updated Insider’s Guide to Obamacare’s Open Enrollment.
The “expert” behind the guide is contributor Louise Norris, whose stellar coverage of all things ACA has made her a respected source for major media who cover state health insurance marketplaces.
What’s in the updated guide?
Louise packed this year’s guide full of the information that matters most to plan buyers, including:
- State exchange enrollment dates
- Tips for choosing a health plan that fits your budget
- Advice on how to preview 2020 coverage in advance of open enrollment
- The pros and cons of auto-renewing your 2019 plan
- and much more
Have more enrollment questions?
If the guide doesn’t answer all of your questions, you’ll like find the answer you need in one of two dozen enrollment FAQs.
Helpful plan-buying tools
Here are just a few tools that can speed up you plan shopping:
- Obamacare premium subsidy calculator
- Penalty calculator (for 2018 and prior years; there is no longer a federal penalty as of 2019)
- Federal poverty level calculator (to determine eligibility for Medicaid and subsidies)
- Premium and plan estimator – searchable by ZIP code
What’s happening in your state?
Wondering what’s happening with premiums and plan availability in your state? Louise Norris has the latest updates on changes within your marketplace.