The Health Insurance Marketplace has been open since October 2013, and its open enrollment period ends March 31. One University of Alabama at Birmingham health policy expert hopes to help alleviate confusion surrounding signup.
The Affordable Care Act, signed into law March 2010, mandates that Americans have at least minimum health insurance coverage. The Marketplace was created to help uninsured people find coverage, and around 5 million people have enrolled.
“The number currently enrolled is down from original estimates that the Congressional Budget Office had of 8 million, and they recently lowered their expectations to 6 million,” said Michael Morrisey, Ph.D., director of the UAB Lister Hill Center for Health Policy. “Things are going much better than they were in the early days of the open enrollment period, but it’s clear they are not going to meet original projections.”
Morrisey believes a combination of factors led to the lower numbers.
“I think there was the whole fiasco of how the website was rolled out and how it didn’t work,” Morrisey said. “The changing regulations over the last few months haven’t helped, and I think there’s genuinely a lot of confusion. Insurance is a complicated thing, and so it’s not unusual that people would have questions.”
Some of the estimates, Morrisey says, suggest as many as 60 percent of people say they are confused about whether they need coverage, how to get it and what the Marketplace is.
Morrisey says there are several ways to get help:
- Visit the healthcare.gov website — if terminology is confusing, access the glossary page for help; if in need of process help, access the one-page Get Covered guide
- Talk to a navigator — these are people or organizations in your community that are trained to help with applying; here's how to locate them
- Ask a relative, a friend, or people at your church or your place of employment who already have coverage to walk you through the process
| “If you don’t have coverage and don’t fall into an exemption from needing it, it’s time to go to the website and see what is available and what it will cost. Some will be eligible for a subsidy, and the premiums for them will be relatively modest.” |
Morrisey says every U.S. citizen and those legal residents who have been here more than five years are mandated by law to be covered, or a penalty can be incurred.
“The penalties are basically 1 percent of your income, with a minimum penalty of $95,” Morrisey said. “But what people should appreciate is that 1 percent can be much higher than that minimum; if your income is $40,000 a year, the penalty will be $400.”
There are some exemptions to the minimum coverage rule.
“There are many people who are not subject to the mandate or who will not be subject to the penalty even though they are required to have coverage,” Morrisey said.
Those most notably not required to get coverage include:
- Those who do not file federal income tax returns
- Those who would have been eligible for the expanded Medicaid program, but their state did not expand the program
- Those who had their coverage cancelled — there are often things one has to do to document, so keep the cancellation notice
“If you don’t have coverage and don’t fall into an exemption from needing it, it’s time to go to the website and see what is available and what it will cost,” Morrisey said. “Some will be eligible for a subsidy, and the premiums for them will be relatively modest.”
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