This year’s Obamacare open enrollment period, which started Nov. 1 in most states, is full of uncertainty and confusion for the more than 24 million people who buy health insurance through the federal and state Affordable Care Act marketplaces.
Even with sign-up season underway, the fate of the enhanced premium tax credits that make coverage more affordable for 92% of enrollees remains up in the air, with the prospect of significantly higher premiums looming.
But there are steps marketplace shoppers can take to ensure they make the right choices for the upcoming plan year.
1. Understand How We Got Here
In 2021, as part of a covid-era relief package, the ACA premium tax credits were enhanced to lower costs for previously eligible people and expand eligibility to people with incomes over 400% of the federal poverty level (which amounts to about $63,000 for one person in 2025). But those enhancements, which were extended in 2022, will expire at the end of 2025 unless Congress acts.
The debate over whether to extend them again has been at the center of a political battle of wills between Republicans and Democrats in Congress, a fight at the heart of the now month-old government shutdown.
The financial implications for many marketplace enrollees are huge. Average out-of-pocket premium payments for subsidized enrollees are projected to more than double if the enhanced tax credits expire, according to KFF, a health information nonprofit that includes KFF Health News.
“The longer this goes on, the more damage is done,” said Cynthia Cox, a vice president and the director of the Program on the ACA at KFF. “If someone logs on Nov. 1 and sees their premium doubling, they might just walk away.”
That would be a mistake, marketplace experts agree. What is clear, though, is that buyers need to beware and be informed.
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