After a year of trying to repeal Obamacare, has anything changed?

After a year of trying to repeal Obamacare, has anything changed?

In some ways, it’s remarkable we made it to open enrollment at all. 

This time last year, repeal seemed imminent. No one could say with any certainty that the ACA would still be functioning in time for open enrollment.

Repeal seemed likely throughout the year, too. Plenty of plans were proposed, but at the end of the year, all it amounted to was noise. For the fifth year in a row, open enrollment rolls on. 

But a year of attempting to repeal the law has introduced more confusion into an already complex situation. Consumers have questions: Can I continue my plan from last year? Am I still required to sign up for coverage? 

Let’s take a look at what has, and hasn’t, changed.

What’s new?

The Trump administration is now responsible for the oversight of the ACA, and is able to make some changes to the law without Congress.

A big change is that open enrollment will be significantly shorter this year. Under the Obama administration, open enrollment extended to the end of January, but that is not the case this year. The Trump administration has shortened the period, so consumers only have until Dec. 15 to sign up.

Another change for consumers is that premiums will be higher in 2018. This was always going to be the case — premiums go up every year — but they will cost more than they might have otherwise due to federal action.

Trump signaled throughout the year that he would cut government payments to insurers. This led insurers to hike their 2018 rates by about 15 percent more than they would have if the payments were assured. Then he followed through, cutting the payments for 2018 by executive order.

Consumers eligible for premium subsidies will not be negatively affected by the higher rates — more on this below — but those paying the full price of insurance will be. 

Lastly, the change that will affect most consumers is insurer shakeups. A few carriers decided not to sell individual coverage for 2018, including Humana in Nashville. However, Nashville consumers will have a new option for 2018, Oscar Health.

More:Nashville, here are your Affordable Care Act options

What hasn’t changed?

First and foremost, Obamacare is still the law of the land. Consumers are still required to buy insurance. Every county in the U.S. has at least one option, and the premium subsidies for consumers under 400 percent of the poverty line are still available. Let’s review each of these.

The individual mandate means that consumers are still required to report whether they had insurance on their tax returns, and will face a penalty for lacking coverage in 2017. This is a source of confusion, but the IRS has confirmed on more than one occasion that it will be enforcing the mandate. 

Every county in the United States has at least one option, which was not guaranteed. Several insurers exited the individual market over the last few years, and at one point there were at least 45 counties at risk of having no carriers for 2018. But little by little, all the bare counties were filled, and consumers in every part of the country have at least one option.

Consumers at or below 400 percent of the federal poverty line will still be able to receive subsidy payments to offset the cost of insurance. In fact, the Kaiser Family Foundation estimates that 54 percent of consumers eligible for subsidies could enroll in a bronze plan for $0. 

The bottom line for consumers needing coverage in 2018 is that the ACA is still in place. The marketplace is open, and plans are available through Dec. 15.

Alex Tolbert is the founder of Bernard Health, a company that provides noncommissioned, expert advice on health, Medicare and COBRA insurance and medical bill consulting. To learn more about Bernard Health, visit www.bernardhealth.com.