As ACA Enrollment Opens, What You Need to Know

Date: November 01, 2017

Related Content: Analysis Healthcare National

The number of Americans enrolling in Affordable Care Act health insurance plans is likely to dwindle. Here’s why.

With the Affordable Care Act open enrollment period beginning this week, there’s much speculation over the marketplace’s future. In each of the past two open enrollment periods, more than 12 million consumers enrolled in ACA plans, according to the Center on Budget and Policy Priorities. Many are predicting that it’s unlikely 2018 will see that level of coverage. Here’s what you need to know:

Enrollment period shortened

The sign-up period on and state marketplaces kicked off November 1, 2017. But this year’s open enrollment period is half as short as last year’s, which ran from November 1 through January 31. This year, the ACA open enrollment period will run from November 1 through December 15. Although, states in charge of their own marketplace enrollment are making their enrollment periods longer than

Premiums spike in 2018

After the current administration’s ending of cost-sharing reduction (CSR) payments, many health insurers were forced to raise their premiums in order to manage costs without the security of these subsidies. Insurers also justified rate hikes because of uncertainty over whether the ACA will face more policy changes.

Use this interactive map to see how individual premiums are skyrocketing on the 2018 ACA marketplace across the country. So far, at least five states are seeing premium increases of over 40 percent on average. How does your state compare?

Individual mandate under threat

Insurers are also uncertain over whether the individual mandate would be repealed or at the very least, not enforced. The Trump Administration has called for a repeal of the ACA individual mandate through the tax reform bill this week, according to Bloomberg. The unpredictability over whether the individual mandate will be scrapped is also the source of many insurers’ efforts to raise premiums.

Cutbacks on outreach impact enrollment

The Trump Administration has cut back on outreach spending and efforts to assist in the enrollment process, which will likely lead to fewer enrollees in 2018. The Centers for Medicare and Medicaid Services is reducing its consumer outreach and education spending by 90 percent this year, according to the Center on Budget and Policy Priorities.

Of surveyed uninsured adults, two out of five had no knowledge of the marketplaces as of spring 2017, and half didn’t know about the marketplace financial assistance as of early last year. Marketing and outreach efforts serve to fill the gaps in information.

Disorientation over ACA repeal prevalent

Because of the lengthy effort to repeal the ACA, many American consumers are confused over whether the ACA was actually repealed and if ACA coverage even exists. In early October, a survey revealed that 39 percent of voters thought the ACA had been repealed, either fully or partially. Young voters represented a strong percentage of those who held that misunderstanding.

With many consumers lacking proper information and struggling to navigate the ACA system—coupled with premium hikes—enrollment rates are likely to decline. “The cost of healthcare has been the number-one problem for small businesses for more than 30 years,” said NFIB President and CEO Juanita Duggan. Any efforts to reform or eliminate the ACA’s obstruction of health insurance coverage will be a step in the right direction for small business.


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