Ron Bliss: Enrollment period cut in half in hopes of lowering premiums, adding choices
April 18, 2017
In the next month, insurance companies will be filing rates for 2018 plans both on and off the Federal Marketplace.
Congress has run out of time to repeal and replace Obamacare for next year because of the need for insurance companies to have necessary information to set rates — which are presented to state insurance divisions for approval each spring.
So all that can be done now is make changes to the existing healthcare law and the Centers for Medicare & Medicaid Services (CMS) has done its part to increase choices and encourage stability in health insurance markets.
Late last week, the CMS reduced the enrollment period for 2018 from three months to 45 days. As it did last year, open enrollment will begin on Nov. 1, but this year it will end on Dec. 15. In 2017, it extended to Jan. 31.
By making the change, the CMS hopes to stabilize individual and group markets, lower premiums and increase choices.
While premiums did not increase significantly in either Nevada or California for 2017, they jumped significantly in certain states and that played a role in Donald Trump winning all of those states in the 2016 election.
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The leaders in rate increase were Arizona at 116 percent, Oklahoma at 69 percent, Tennessee at 63 percent, Alabama at 58 percent and Pennsylvania at 53 percent. One-third of the counties in 2017 offered only one insurance company on the exchange and five states offered only one choice. The national average increase for 2017 was 25 percent for the average silver plan in each state.
Newly-appointed CMS Administrator Seema Verma said by shortening the enrollment period the CMS hopes it will help increase choices and lower premiums.
"CMS is committed to ensuring access to high quality affordable healthcare for all Americans and these actions are necessary to increase patient choices and to lower premiums," said Verma. "While these steps will help stabilize the individual and small group markets, they are not a long-term cure for the problems that the Affordable Care Act has created in our healthcare system."
By changing the end of enrollment from Jan. 31 to Dec. 15, it will put the open enrollment period more closely in line with the Medicare Annual Enrollment Period (AEP) that runs from Oct. 15-Dec. 7 each year.
Whereas the longer enrollment period allowed individuals to only be enrolled from nine months out of the year and avoid a tax penalty, now they will need to be enrolled for 12 months — which will bring in more money for insurance companies and encourage them to lower premiums.
If individuals miss the enrollment period, they will not be able to have an ACA plan unless they have a qualifying life event that would lead to special enrollment. Even that will be made more difficult.
In 2018, individuals will need to provide proof of eligibility BEFORE the insurance is provided. The idea is to encourage them to stay enrolled all year — not just long enough to avoid a penalty.
The CMS is hoping the rule changes will result in insurers offering more choices for 2018 because of the assurance of 12 months of premium payments.
Ron Bliss is an independent insurance agent who assists individuals with healthcare of all types, to include short-term plans, health supplements and Medicare Supplements. You can reach him as 775-224-7169.