20% of Americans Wonder — What Is Open Enrollment?


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Written by Guest | Last Updated November 26th, 2019
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HealthPocket infographic of research with chartsGuest Post by Jan Dubauskas

The Affordable Care Act’s Open Enrollment is in full swing across the country, but a recent HealthPocket survey found that almost 20 percent of respondents don’t even know what open enrollment is and another 20 percent of respondents don’t realize the ACA is still available in the marketplace.

Consumers are confused about something that according to the new survey from HealthPocket, a free information source designed to help consumers find medical coverage, is the second most important topic in the next Presidential election. In fairness, there have been a lot of changes to health insurance over the last 10 years that have left us all wondering if we’re up to date on the latest rules. Let’s take this opportunity to discuss open enrollment and why it is important for consumers.

What is Open Enrollment?

Open enrollment is a period of time each year, typically November 1–December 15 in which people searching for coverage from the ACA can buy health insurance plans that start on January 1 of the following year. For example, an ACA plan purchased on December 4, 2019 will be effective January 1, 2020.

Although most consumers are covered by an employer plan or by a government plan, according to the HealthPocket survey, almost 20 percent of consumers either purchase their own coverage or are uninsured. Open enrollment is designed to help those consumers find coverage.

The open enrollment time period is important because under the ACA, consumers cannot buy an ACA plan outside of the open enrollment unless they have a special circumstance like losing coverage from a job or divorce. Because of the importance of the timing, Americans who are not covered by their employers are in a desperate search for the right health care coverage at the most affordable rate.

Unfortunately, according to the same survey from HealthPocket, more than 40 percent of respondents found it difficult to afford their current monthly premiums with a similar number saying their premiums are on the rise.

Health care costs are increasing

Higher costs are forcing more and more people to take a hard look at their budget and in some cases, forgo purchasing insurance altogether. In fact, nearly a third of those surveyed admitted that they would consider skipping health insurance since the tax penalty for going uninsured was lifted in January 2019. Considering that the goal of the ACA was to insure more people, it is striking to consider that plan costs are driving consumers to reconsider whether they need health insurance at all. On the other hand, perhaps it is not so surprising given costs are escalating at a trajectory that is simply not affordable for so many.

More telling, however, is that essentially 100 percent of those surveyed said they are aware that other health care options exist outside of employer provided coverage and the ACA. Those numbers seem to present a conundrum — how can 100 percent recognize there are other options besides the ACA and still one-third say they are willing to forgo coverage?

It’s possible many of those people are unsure if one of the more prominent options is available — short term medical coverage or temporary insurance. The fact is, while some view short term medical insurance as the antithesis of the ACA, short term has long provided affordable coverage for those who do not have employer provided health care and is still available for purchase. It is designed to provide coverage for unexpected accidents and illnesses. Short term plans are now available to be sold in 12-month increments with the option to renew for up to 36 months.

Health care is a personal and political issue

Setting aside the differences found in the HealthPocket survey, there is one other area in which people largely agree. More than two-thirds of respondents said that providing affordable health care for Americans is a political issue. When asked their most important issue going into the 2020 election, health care is a very close second to the economy.

Recently, the Department of Health and Human Services announced rules to implement pricing transparency for hospitals with online tools to help consumers understand the rates hospitals charge for their services. The assumption is that more transparency on hospital pricing will expose hospitals that overcharge and, in time, prices will reduce and become more predictable. These rules will come into effect starting January 2021.

Open Enrollment for 2020

For a large segment of the population, costs today are simply too high to afford many of the current health care choices, particularly the ACA. Further, while Americans know they have options like short-term medical, they are still considering the idea of not enrolling in any sort of health care coverage at all.

During this open enrollment period, it is important for consumers who are uninsured or who are purchasing a plan, to consider their health care needs and their budget to purchase a plan that will provide the coverage they require at a price they can afford.

Jan Dubauskas is a health care expert, enthusiastic insurance pro, and mom serving as Vice President and Senior Counsel at Health Insurance Innovations, Inc. (HIIQ), a market leading cloud-based technology platform and distributor of innovative health insurance products that are affordable and meet the needs of health insurance plan consumers.

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