Obamacare future up in air as enrollment deadline nears

On Jan. 20, Donald Trump will be sworn into office as the 45th President of the United States. While the inauguration will finally bring one of the most contentious election cycles in recent history to an end, there are still plenty of questions as to what the future holds under the Trump administration.

One of the biggest among them is how it will impact the Affordable Care Act (ACA), a cornerstone of Barack Obama’s presidency and the program through which 22 million Americans currently receive health care coverage.

The incoming administration has made it clear that repealing ACA, better known as Obamacare, is a top priority. What it will be replaced with is not as transparent at this point. For now, anyone looking to shore up their health insurance under ACA for the year ahead must act quickly. The deadline for enrollment is Jan. 31.

The Affordable Care Act has brought the country’s uninsured rate to its lowest point in 50 years, according to the U.S. Department of Health & Human Services (HHS). So despite the uncertainty of the program’s future, health care policy experts see it as a part of Obamacare’s lasting legacy.

“I think that’s the biggest impact,” says Karen Pollitz, a senior fellow at the Kaiser Family Foundation. “We’ve covered [22]million more people.” The ACA has made health insurance more accessible than ever, but critics of the program have balked at its ability to make it more “affordable,” citing spikes in premiums — the main factor beneficiaries consider when picking a plan — as a weakness.

Late last year as open enrollment got underway, the HHS announced that, on average, premium rates for plans in the federal marketplace would increase by 22% for 2017. New York State, which operates its own marketplace, New York State of Health, announced its plans’ premium rates would rise by an average of 16.6% for individuals and 8.3% for small businesses.

Before the double-digit price hikes have you hyperventilating, it’s worth noting that despite the increase in New York State, premium rates are still 55% less than they were before the state marketplace was established. Premium rates alone are not enough to determine the true cost of your health coverage, as cost sharing reductions like tax credits can

help reduce out-of-pocket expenses for those who are eligible.

Eric Gascho, vice president of Government Affairs for the National Health Council, says the most important thing people can do when enrolling in a plan is to understand that subsidies exist, and they should be aware of what they need to do to be eligible to receive them.

“It’s worth taking a look to see what’s out there,” says Gascho, who advises using a financial aid calculator that can be accessed online at either healthcare.gov or nystateofhealth.ny.gov.

Those who take the time to explore what subsidies are available to them could find the process rewarding. On average, Americans received $272 per month in premium tax credits in 2015, according to the HHS.

Eligibility for a premium tax credit kicks in if your annual income is between 200% to 400% of the federal poverty level. In New York, if your household income is at or below 400% of the federal poverty level, you should consider enrolling in the state’s Essential Plan, which caps its premiums at $20 per month for beneficiaries. Depending on your income, you could pay no monthly premium at all for coverage.

Essential Plans cover the same essential benefits as all health plans under the Affordable Care Act, with the additional benefit of having no deductible and free preventative care services.

There are plenty of questions to consider when picking an insurance plan, such as how much you can afford to pay out of pocket for your coverage, how much health care you’ll potentially require in the year ahead, and whether you’re having a baby or need to schedule a surgery. All these factors can play a role in determining the right plan for you.

For those who need help navigating the enrollment process, both Pollitz and Gascho recommend reaching out to in-person assisters or certified application counselors for help. More information about assistance options in your area can be at healthcare.gov or nystateofhealth.ny.gov. Both sites also feature tools to help you navigate the enrollment process on your own.