ACA open enrollment for 2019 begins

The Affordable Care Act’s insurance marketplaces open for a sixth year Thursday with slightly higher but more stable health plan rates and choices plus significant tests of the effects of recent Republican moves to undercut parts of the law.

During the enrollment season — which lasts six weeks, half as long as it used to be — consumers may buy the health coverage created under the ACA. This is the first enrollment since Congress removed the law’s penalty for people who fail to carry health insurance. With that federal fine scheduled to vanish in January, this year’s marketplaces will furnish evidence for a longsimmering debate: How much of the nation’s gains lately in health coverage have happened because of the law’s insurance mandate, and will coverage tumble without it?This enrollment season will also be the first since the Trump administration has been taking steps to circumvent the ACA’s insurance requirements, making it easier for individuals to buy two inexpensive types of insurance that cover less care and lack certain popular consumer protections.

Administration officials tout this alternative coverage, shortterm health plans and “association health plans,” as expanding affordable options, while critics predict it will confuse consumers.

The marketplaces were intended to help individuals and families who cannot get an affordable health plan through a job. In the states relying on the federal marketplace, consumers sign up mainly through the HealthCare.gov website and federal call centers.

Eleven states and the District of Columbia run exchanges; several of those are planning a longer enrollment period, through December or into January.