No, President Trump and the Republican Congress haven’t “repealed and replaced” President Obama’s Affordable Care Act (ACA), the federal health care law, yet.
But yes, as Open Enrollment began on Nov. 1, there are significant changes than in previous years.
Here in North Carolina, the enrollment period via the 2018 Federal Health Insurance Exchange ends on Dec. 15 for coverage to begin January 1, 2018. This is the shortest enrollment period (45 days) in recent years, so those without health care coverage elsewhere need to act immediately.
And in order to qualify for federal tax subsidies to offset the rising cost of health insurance premiums, those seeking to apply should go online to www.healthcare.gov. An estimated 496,420 NC residents—85% of those insured by Blue Cross Blue Shield of North Carolina (BCBS) through the ACA—are eligible for Advanced Premium Tax Subsidies (APT).
The average ACA health insurance premium is calculated at $662 per month, but after the APT subsidy tax credit kicks in, comes down to just $129 per month, and in some cases, as low as $87 monthly.
BCBS is the only ACA health insurer in all 100 North Carolina counties, insuring 502,000 residents. It has been given the green light by the NC Dept. of Insurance to raise ACA insurance rates by an average of 14.1% for 2018 coverage (the insurer originally asked for 22.9%). Federal premium subsidies, however, would also increase to cover at least part of that increase.
Reportedly, 549,158 North Carolinians signed up for the ACA last year, a decrease of approximately 64,000 from the number of residents who signed up in 2015. Observers say one reason for the decrease was uncertainty about the future of the ACA, especially after Pres. Trump won the 2016 presidential election. His campaign insisted he would repeal the federal law, though he and the Republican Congress have repeatedly failed to do.
In addition to shortening the enrollment period by half (from 90 to 45 days), Trump has cut the advertising budget to inform Americans of Open Enrollment by 90%, from $100 million to $10 million. He has also cut federal funding to nonprofit groups that traditionally helped low-income residents navigate the process of signing up and qualifying.
Despite these cuts, more than 200,000 people enrolled on the first day (twice as many as last year), and visits to healthcare.gov numbered over 1 million (a 33% increase).
The White House has also discontinued the cost-sharing reimbursements to insurance companies to help offset rising premiums to consumers. As a result, premiums across the nation have gone up anywhere from 15 to 21 percent, according to published reports.
North Carolina residents “are guaranteed to be insurable and are encouraged to sign up for health insurance….” through the ACA if they: currently have ACA coverage, but want to change their plan for 2018; do not have insurance through their employer or spouse’s employer; don’t have other government coverage (VA benefits, Medicaid, or Medicare); or are older than 26 and are no longer on their parents’ policy.
According to the ACA legislation, failure to have health insurance in 2018 will result in a sizable tax liability: $695.00 per uninsured adult, and $347.00 per uninsured child, or 2.5 percent of household income, whichever is higher. However, the Trump Administration has told its IRS commissioner to find ways not to enforce that penalty.
Also, per new rules that are now in effect, insurance companies can now deny you coverage if you owe them money on current coverage. You must settle any outstanding balances before you will be re-enrolled.
You can also be denied the premium tax credit to lower your bill in 2018 if you’re behind in your taxes. To correct this, fill out the federal tax reconciliation IRS form 8962 to determine your 2016 taxable income.
For more information, call the NC Dept. of insurance to speak to a consumer specialist at (855) 408-1212.