About this guide: Insider’s Guide to Obamacare’s Open Enrollment

What’s in our updated Guide to Open Enrollment?

Obamacare’s fourth open enrollment should be smooth sailing, but just to be sure, our updated guide has everything you need to know.

  • By
  • healthinsurance.org contributor
  • August 20, 2016

Obamacare’s fourth open enrollment period will begin on November 1, 2016. The glitches and problems that defined the first open enrollment period are well behind us, and consumers can expect a relatively smooth enrollment process this winter.

But that doesn’t mean it’s easy or that all aspects of selecting and enrolling in a plan are simple or intuitive. Even if you’re already enrolled in a health plan for 2016, the options that will be available to you for 2017 will likely be different.

Changes for 2016-2017

Here are just a few examples of the changes covered in our updated guide:

  • Subsidy eligibility levels will increase slightly to reflect the increased 2016 federal poverty level, and for the first time, carriers will have the option of offering standardized health plans through HealthCare.gov.
  • Provider networks and drug formularies will continue to change and evolve, and tiered network plans may become more popular with consumers and health insurance carriers.
  • The maximum out-of-pocket allowed under the law will be higher in 2017 than it was this year, and health insurance carriers will keep pace with the new guidelines, offering plans with higher out-of-pocket maximums in order to keep premiums as low as possible. (They will also continue to offer a wide range of plans with out-of-pocket maximums well below the upper limit allowed by law.)
  • The federal government has issued another extension that gives states the flexibility to allow grandmothered/transitional health plans in the individual and small-group market to renew again for 2017, and many states have opted to go along with the extension. So if you’ve got a grandmothered health plan, you may be able to keep it for 2017 (though that might not be your best option, and you’ll want to compare it with the full range of new plans available in your area during open enrollment).
  • Across the country, several insurers are exiting the exchanges altogether at the end of 2016, in larger numbers than we’ve seen in prior years. This will have an impact on enrollees’ plan choices for 2017, and also on the auto-renewal process. It’s highly recommended that you return to the exchange to pick your own new plan if your carrier is leaving the exchange, but HHS has also implemented a new protocol under which they will — if possible — select a new plan for you if you don’t select one yourself.

Signs of success for consumers

As of March 2016, more than 11 million people were enrolled in effectuated individual health insurance plans through the exchanges, and Medicaid enrollment grew by 15.5 million people during the first two years after Medicaid was expanded under the ACA. As a result, the uninsured rate among U.S. adults had dropped to new low of 11 percent by the first quarter of 2016. (It’s even lower when children are included, as they’re less likely to be uninsured than adults.)

There’s still a long way to go though. Nationwide, 17 states still had at least one in every eight residents uninsured in 2015. And in 18 states that have not yet expanded Medicaid, there are still 2.9 million people in the coverage gap, with no realistic access to any sort of health insurance.

But we head into the fourth open enrollment period for individual health insurance, there’s an ever-increasing awareness of the improvements wrought by Obamacare. And there are also still plenty of questions and misperceptions, which is where this guide comes in. We hope it will make the decision-making and enrollment process easier for you once open enrollment begin.