Oct, 30, 2015

What to Expect from Open Enrollment 2015-2016

This Sunday, November 1, marks the start of the third annual Open Enrollment period for health coverage under the Affordable Care Act. Eligible Americans can shop for plans that will take effect on January 1, 2016. For most, this means the annual trip to healthcare.gov to review options and update personal information. What can be expected from this year’s open enrollment – the shortest period so far?

Technology Improvements – While it is hard to forget the glitch-plagued rollout of Health Insurance Marketplaces two years ago, buggy software is largely a thing of the past. Residents of 38 states will be able to visit a revamped healthcare.gov which features new tools to help consumers choose the right coverage based on their preferred providers, prescription drugs and expected health care needs and costs. Additionally, the site has been moved to a new hardware platform, and federal officials are expecting a 40-60% increase in the speed of the site. The 12 states that use their own technology for their Health Insurance Marketplaces have also made system improvements to make shopping easier than ever.

Low to Moderate Premium Increase (Generally) – By allowing consumers to compare prices and plans on the Marketplaces, they have the opportunity to choose a plan that continues to fit their financial needs every year. In general, the average increase of the benchmark plan – the plan on the marketplaces that sets the level of subsidy available to purchasers – is increasing by about 7.5%. This average, though, is national and individual states could see a wide variance from the average. Additionally, individual plans that are not the benchmark plan could see very large premium increases. Because subsidies are pegged to the second lowest-cost silver plan, which have changed in many markets, consumers will need to shop to ensure they are getting the best deal.

Less Advertising – As enrollment in Marketplace coverage reaches more of a steady-state, the federal government and state Marketplaces have scaled back their marketing plans. This will mean fewer billboards and a quieter presence on television and radio. Many of the state Marketplaces, faced with the loss of federal grant funds, will also scale back on the number of assistance sites and counselors available to help consumer renew or sign-up for coverage. As a result, more Marketplaces are using insurance brokers to assist consumers in selecting coverage.

Modest Increases in Coverage – Secretary of Health and Human Services Sylvia Burwell recently announced the enrollment target for Marketplaces – 10 million enrollees, up from the current 9.1 million. The relatively flat increase is partially attributable to the fact that most people who want and can afford the coverage have purchased already, and the penalty for going without coverage is still too low to drive more purchasing. Additionally, a group of current enrollees may find themselves ineligible for financial assistance and priced out of coverage because they failed to file the necessary tax forms to account for subsidies received in 2014.

Overall, while little related to the ACA is proving to be non-controversial, expect this Open Enrollment period to be quieter than the first two. While a sharp increase in enrollees is not expected, another year of things working well and smoothly for consumers will increase the likelihood of the Affordable Care Act becoming a permanent fixture of our nation’s health coverage system.