We're ten days into 2018 federal open enrollment and, following repeated attempts in Washington to repeal, replace or neuter the Affordable Care Act (ACA), things are going ... well. Official government numbers show over 600,000 people signing up for a plan on Healthcare.gov, a stat in line with past years or potentially even higher in totality, given it excludes state-run exchanges.
It's too early to tell if the pattern will hold. Federal open enrollment is shorter this year than last (it ends on Dec. 15!), so there's a sense of urgency associated with getting healthcare in 2018 that could account for spikes in early activity.
But here's something that'll stick: Per new numbers from the Kaiser Family Foundation, more than half of the 10.7 million people eligible for a 2018 ACA plan can expect to pay less in premiums than they would in the tax penalty associated with skipping coverage. That penalty — which the IRS has said is extra-mandatory this year — is either 2.5% of your income above the minimum required to file a tax return or $695, whichever is greater.
There's a kicker in Kaiser's data, too: About 4.5 million people can get a Bronze plan for $0 in 2018.
How is this happening?
Thank President Donald Trump, who elected to stop making cost-sharing reduction payments to insurers back in October. The move, as expected, caused insurers to raise premiums to make up for the lost funding. But many savvy state regulators asked companies to front-load increases onto Silver plans.
Why? Because their prices dictate how much in the ACA's other big subsidy — its premium tax credit — low-income Americans qualify for. Basically, the higher the Silver plan price, the higher the premium tax credit. And, since that credit gets applied to any ACA health plan and cheaper Bronze plans were shielded from a price hike — viola! — $0 ACA health insurance was born. (If you're confused by all this metallargy, we've got an explainer on Obamacare's metal tiers.)
What does this mean for me?
It depends. Premium tax credits are only available to people who earn between 100% and 400% of the federal poverty level, so if you don't fall into that bracket, you won't be eligible for de facto free healthcare. In fact, your quoted premiums might be high. If so, you should probably at least scout off-exchange plans in your area. These policies aren't subject to the more stringent ACA rules, so they're often cheaper for people who don't qualify for subsidies.
Remember, too, prices and plans vary by state, so, if you live in one with a weak exchange, you probably won't encounter a plan that cheap.
Finally, Bronze plans only cover about 60% of your healthcare costs each year and tout a high deductible, so resist the urge to opt for one just because it has a $0 price tag. Pricier, but more robust, Gold plans were shielded from premium increases in certain states, too, so there's a chance you might find one that's affordable as you shop around.
Bottomline: Comparison-shopping for healthcare is more important than ever before. We can help you assess your 2018 ACA health insurance options here.
Not to play spoiler, but anecdotal evidence Policygenius reporter Myles Ma has been gathering from people getting health insurance on the exchange intimates Obamacare 2018 is a real mixed bag. While some people — largely those who qualify for subsidies — are finding plans that cost less than what they paid last year, other Americans are getting priced out of the market or pushed into other alternatives. You can follow Myles' series "Finding Healthcare" over in our HealthGenius section.
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