The 2018 Open Enrollment period is behind us. We now have a new Tax Bill that has ended the Individual Mandate, which required everyone in the U.S. to have ACA Compliant health insurance. Now what?
Although the Mandate has been eliminated, it’s still in effect for 2018.
You may qualify for an exemption to ObamaCare (aka the Exchange)
You’ll see these referred to as ‘Hardship Exemptions’. There have always been several exemptions available to the ObamaCare requirement that allow you to enroll into an ACA Compliant health insurance plan:
https://www.healthcare.gov/health-coverage-exemptions/hardship-exemptions
These exemptions can be executed whether you choose to be uninsured or you choose a plan that has been approved in Colorado or Wyoming outside of the ObamaCare (Affordable Care Act) mandates. Or, really any state in the U.S.
During the just-completed Open Enrollment period, I most frequently interacted with individual insurance enrollees, self-employed and small business owners who earned too much to qualify for a subsidy but simply couldn’t afford the least expensive Bronze Plan as offered on the Exchange.
How does it work? Consider Layla and her husband John in Steamboat Springs, CO. Small business owners earning more than the income threshold of $64,960 for a tax filing household of two; they cannot qualify for a federal subsidy. Both 49 years old, the least expensive Family Bronze Plan available to them would cost $1,725 per month ($20,700 per year).
Does $20,700 exceed 8.16% of Layla and John’s (projected) household income for 2018? Put another way, will Layla and John’s Modified Adjusted Gross Income (MAGI) exceed $250,000? If not, then the cost of an ObamaCare compliant plan will NOT exceed 8.16% of their household income and they will qualify for an exemption from the individual mandate.
Yes, as you can imagine, a great percentage of individuals across Colorado and Wyoming and the rest of the U.S. will find that they can qualify for this exemption. What can they do next? If there is only one guaranteed issue, ObamaCare compliant plan available to them, what else might they do?
Move forward like Layla and John did and choose an Off-Exchange Plan that taps them into the Cigna PPO Network with a similar deductible for less than half the monthly premium. We’ll see more of this as we move forward and further away from the individual mandate. Unfortunately, 2019 is likely to be worse than 2018 for people who do not qualify for a federal subsidy for the simple reason that the health insurance industry isn’t prepared to offer the individual or self-employed business owner a viable alternative to ObamaCare that includes an unlimited lifetime claims benefit. There are only two such plans like that which are available right now.
There is no Open Enrollment period for Off-Exchange Plans. You may enroll into these Plans at any time of the year, if you qualify. You may find that you will save over $10,000 in health insurance premium cost during 2018 like Layla and John.