When can you get health insurance for 2018?
- Open enrollment was Nov. 1 to Dec. 15, 2017 in all states that use HealthCare.gov.
- Nine states have announced open enrollment extensions.
- Hurricane victims can enroll through December 31 as part of a special enrollment period.
- Other than in Nevada, you cannot enroll outside of open enrollment unless you have a qualifying event.
- In states where the OEP ends Dec. 15, all plans will be effective Jan. 1.
- Schedule for 2018’s OEP (in the fall of 2017) was changed in April 2017.
- Limited enrollment prevents people from waiting until they’re sick to enroll.
State-run exchanges were encouraged to follow the same schedule, although the Department of Health and Human Services (HHS) has acknowledged that state-run exchanges might run into technical difficulties since the open enrollment schedule was changed late in the game, in April 2017.
Enrollment extended in nine states
Ultimately, ten of the 12 state-run exchanges that operate their own enrollment platforms announced extensions to open enrollment. You can see more details on this page devoted to open enrollment specifics. In summary, the following state-run exchanges pushed out their enrollment deadlines for 2018 coverage:
- Connecticut: December 22
- Maryland: December 22
- Rhode Island: December 31
- Colorado: January 12
- Minnesota: January 14
- Washington: January 15
- Massachusetts: January 23
- New York: January 31
- DC: January 31
- California: January 31
Extension for Hurricane victims until December 31
To be eligible for the SEP, you have to reside in (or have resided in at the time of the hurricane) one of the counties that FEMA declared eligible for “individual assistance” or “public assistance.”
- The entire state of Georgia
- The entire state of Florida
- The entire state of South Carolina
- The entire state of Alabama
- The entire state of Maine (due to windstorms in late October)
- 32 parishes in Louisiana (listed here, here, and here)
- 53 counties in Texas
- 7 counties in Mississippi (including Greene County, which is on this map for disaster designation DR-3450)
- Anyone who lived in Puerto Rico or the U.S. Virgin Islands when the hurricanes hit. The bulk of the ACA’s provisions were not implemented in the territories, so there’s no open enrollment period in Puerto Rico or the Virgin Islands. But people who lived there during the hurricanes and are now living in one of the US states can enroll in health insurance through December 31 using the special enrollment period (they can also enroll for up to 60 days following their permanent move from a territory to a state; depending on when they moved, that could extend past the December 31 deadline for the hurricane SEP).
Special enrollment and exceptions
Regardless of whether you purchase insurance through the exchange or off-exchange, the annual Obamacare open enrollment window applies. Nevada is an exception – coverage is available there outside the exchange year-round, albeit without subsidies and with a 90-day waiting period before coverage becomes effective.
But in the rest of the country, you cannot enroll outside of open enrollment unless you have a qualifying event.
What happens if you don’t buy during ACA’s OEP? [link]
When will your plan be effective?
In states where open enrollment ends December 15, all plans will be effective January 1. In states with extensions, enrollments after December 15 will generally result in February or March effective dates, but six of the state-run exchanges are allowing people to enroll after December 15 and still get a January 1 effective date.
Any anyone who enrolls during the hurricane SEP will have coverage effective January 1. In addition, people whose coverage is ending on December 31 can select a plan as late as December 31 and still have it take effect January 1.
The changed schedule for 2018’s OEP
In the Benefit and Payment Parameters for 2017, finalized in December 2016, HHS confirmed that open enrollment for 2018 coverage would run from November 1, 2017 through January 31, 2018 (the same November – January schedule that was used for 2016 and 2017).
But in April 2017, HHS (headed by then-Secretary Tom Price, a Trump appointee who resigned in September 2017) finalized market stabilization regulations that include a switch to a shorter open enrollment period in the fall of 2017.
Open enrollment was already slated to switch to the shorter window beginning in the fall of 2018, for coverage effective in 2019 and beyond. The market stabilization regulations just moved up the schedule by one year, starting the shorter open enrollment period in the fall of 2017 instead of the fall of 2018. However, the Trump Administration also sharply reduced funding for HealthCare.gov’s enrollment assisters and marketing, making it particularly challenging to adequately address the needs of people in states that use the federally-run exchange.
Why limited-enrollment windows are normal
We frequently see people lamenting the fact that there’s a limited window in which to purchase coverage, but there are a couple points to keep in mind:
- Limited open enrollment periods have long been the norm for employer-sponsored health insurance, which is where most non-elderly Americans get their coverage. (You can’t just enroll in your employer’s plan anytime you like. You have to wait for open enrollment, unless you have a qualifying event.)
- Medicare also has limited annual open enrollment periods.
- The individual health insurance market used to allow people to purchase coverage anytime they wanted. But insurance companies would ask a long list of medical history questions, and would decline applications from people with serious pre-existing conditions. That’s no longer the case, so the limited enrollment window is necessary to prevent people from waiting until they’re sick to enroll (which would be unsustainable, since insurance only works if there are enough healthy people paying premiums to offset the costs of the sick people).