News & Features

HealthCare.Gov’s Second Open Enrollment Season Arrives

People seeking insurance through federal exchange can start Nov. 15

As another open enrollment period approaches for the controversial Affordable Care Act, the Obama administration is expecting 9.9 million Americans to enroll in private health plans through state and federal exchanges by next year.

The second open enrollment season begins Nov. 15 and ends Feb. 15, 2015. For those who are already enrolled in an insurance plan through the ACA, the benefit year ends Dec. 31. To renew a current plan or choose a new health plan, people need to enroll before Feb. 15. Those who do not have health coverage in 2015 face a fee, which will be higher than in 2014. The fee is 2 percent of a person’s income or $325 per adult and $162.50 per child.

A year ago, 36,584 Montanans selected plans through the federal exchange by the end of the first open-enrollment period.

Federal officials say the HealthCare.Gov website is drastically improved over last year and should avoid the issues that plagued the ACA rollout a year ago.

“Things will not be perfect,” said Health and Human Services Secretary Sylvia M. Burwell, trying to set expectations. “We are aiming for a strong consumer experience, and it will be better.”

This new sign-up period will be the first time that renewal has been tried for current customers, and also overlaps with the first tax-filing season that the law’s requirements are in effect.

Premium increases are expected to be modest in many, though not all, states, according to the Associated Press. New insurers have come into the market, promoting competition, and regulators now take a close look at anything above a 10 percent increase.

The online application for most new customers is down to 16 screens from 76. Website security is better, thanks to aggressive monitoring. The government and insurers have added call center staff.

The Congressional Budget Office has projected that 13 million people will be covered through federal and state insurance markets in 2015. That means retaining most of the 7 million people now covered and adding 6 million more. Many are skeptics who sat out last year’s campaign.

An Associated Press-GfK poll found that 31 percent of those questioned expect the health insurance exchanges to work better, while 49 percent think they will work about the same. Also, 18 percent expect version 2.0 to be worse.

The new open enrollment period comes following Election Day, when Republicans built a heavy majority for 2015. There’s also the Supreme Court’s decision last week to hear another challenge to the law is also casting a shadow.

The health insurance exchanges offer taxpayer-subsidized private coverage to people who do not have access on the job. HealthCare.Gov will serve 37 states, while the rest run their own markets.

Tips for Enrollees:

— For those already signed up, coverage will renew automatically if you do nothing. Sounds good, but maybe not. You could miss out on lower premium options and get stuck with an outdated and possibly incorrect subsidy. Shop around, but don’t delay. You have until Dec. 15 to update your income information or change plans if you want to have everything in place by Jan. 1.

— New customers, be advised: The Nov. 15-Feb. 15 open enrollment is half as long as last time, and it overlaps with the holidays. Try to get familiar with some of the basic health insurance trade-offs. A low-premium silver or bronze plan may not make sense if you’ll wind up with high out-of-pocket costs for the deductible and copayments. In that case, you might be better off going for the gold.

Some of the tax complications lurking:

— Most current customers are getting a tax credit to help with premiums. Those subsidies are tied to income, so you’ll have to file new forms with your 2014 taxes to prove you got the right amount. Too much subsidy and your tax refund will get dinged. Too little, and the government owes you. It’s bound to cause anxiety because many people depend on their tax refunds to pay bills.

— If you remained uninsured in 2014, you risk a penalty that will be deducted from your tax refund. It starts at $95 for those uninsured all year. Millions of people may qualify for penalty waivers, but getting exemptions could be an ordeal. Some appear simple, but for others you’ll have to mail in an application and supporting documents.