Despite Trump, Affordable Care Act (ACA) Open Enrollment Has Begun in N.C.

Despite Trump, Affordable Care Act (ACA) Open Enrollment Has Begun in N.C.

by November 1, 2017

No, President Trump and the Republican Congress haven‘t “repealed and replaced” Pres. Obama’s Affordable Care Act (ACA), the federal health care law, yet. But yes, as Open Enrollment began on Nov. 1st this week, there are significant changes than in previous years.

Here in North Carolina, the enrollment period, now underway, ends on Dec. 15th for coverage through the 2018 Federal Health Insurance Exchange to begin January 1, 2018. This is the shortest enrollment period (45 days) in recent years, so those without health care coverage elsewhere 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 residents –  85% of those insured by Blue Cross Blue Shield of North Carolina (BCBS) through the ACA are eligible for what are known as 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 a month.

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 percent for 2018 coverage (the insurer originally asked for 22.9 percent). Federal premium subsidies, however, would also increase to cover.

Reportedly, 549,158 North Carolinians signed up for the ACA last year for 2017 coverage, a decrease of over 64,000 more who signed up the year before. Observers say one of the reasons for the decrease was uncertainty about the future of the ACA, especially after Pres. Trump won the 2016 presidential election, vowing to mothball the federal law, which he and the Republican Congress have repeatedly failed to do.

The Trump Administration has significantly cut the advertising budget to make more Americans aware of the ACA Open Enrollment period, in addition to shortening it to just 45 days, hoping to slowly phase it out in the future. It has also cut federal funding to nonprofit groups that traditionally helped low-income residents navigate the process of signing up and qualifying.

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; they don’t have health insurance through their employer or spouse’s employer; they don’t have government coverage (veterans, Medicaid or Medicare); or they’re older than 26 and are no longer on their parents’ policy.

Failure in having health insurance in 2018 will result in a sizable tax penalty, official warn. For the past two years, that fee has been $695.00 per uninsured adult, and $347.00 per uninsured child, or 2.5 percent of household income, whichever is higher.

Also keep in mind, 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.

And 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 1-855-408-1212.

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