The Insider's Guide to Obamacare's Open Enrollment 2016-2017

Find affordable health insurance:

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

What’s in our updated Guide to Open Enrollment?

Everything you need to know about Obamacare's fourth open enrollment

  • By
  • contributor
  • January 29, 2017

Obamacare’s fourth open enrollment period began on November 1, 2016, and continues until January 31, 2017. The glitches and problems that defined the first open enrollment period are well behind us, and consumers have seen 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 were already enrolled in a health plan for 2016, the options that are available to you for 2017 are likely to be different.

Changes for 2017

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

  • Subsidy eligibility levels have increased slightly to reflect the increased 2016 federal poverty level, and for the first time, carriers have the option of offering standardized health plans through
  • Provider networks and drug formularies continue to change and evolve.
  • The maximum out-of-pocket allowed under the law will is higher in 2017 than it was in 2016, and health insurance carriers have kept pace with the new guidelines, offering plans with higher out-of-pocket maximums in order to keep premiums as low as possible. (They are also continuing to offer a wide range of plans with out-of-pocket maximums well below the upper limit allowed by law.)
  • The federal government 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 throughout 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 exited the exchanges altogether at the end of 2016, in larger numbers than we’ve seen in prior years. This has had 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 selected a new plan for you in December (effective January 1) if you didn’t select one yourself. In that case, you still have until January 31 to return to the exchange and pick your own plan for 2017 (plans selected in the second half of January will take effect March 1, replacing the plan into which you were auto-enrolled for January and February).

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 2.6 million people in the coverage gap, with no realistic access to any sort of health insurance.

But as we approach the end of 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, if you haven’t yet selected a plan. Keep in mind that open enrollment ends January 31, both on and off-exchange (Minnesota has implemented a special enrollment period that runs through February 8, giving residents there an additional week to enroll).

The future of the ACA under the Trump Administration

Our guide to open enrollment was written in the months leading up to open enrollment. But a week after open enrollment began, Donald Trump won the presidential election, and the future of the ACA was suddenly uncertain. Republicans control Congress and the White House, and have promised to repeal the ACA and replace it with something else (although they have not reached a consensus in terms of what that something else should be).

We have a Repeal & Replace Section devoted to keeping you up to date with the latest news. Our consumer-advocacy perspective considers how various GOP health care reform proposals would impact Americans — particularly those who are most vulnerable in terms of their ability to realistically access health care. Everyone has had different experiences with the ACA, and has different opinions in terms of how to best move forward. If you want your voice to be heard during this legislative session, be sure to reach out to your Senators and Representative and let them know how the ACA has impacted your life.