Thanksgiving Holiday Slows Insurance Enrollment for 2018

Consumers who have not qualified for critical health insurance subsidies to get an affordable plan may be able to get a subsidized plan if they sock money away in a health savings account or a traditional IRA.

Health insurance enrollment on the healthcare.gov marketplace slowed in Oregon over the Thanksgiving holiday, mirroring the trend nationally.

An additional 9,048 consumers enrolled in the week between Nov. 18 to Nov. 25, bringing the statewide total up 21 percent to 51,882. Nationally, enrollment ticked up the same percentage, from 2.3 million consumers to 2.8 million.

Oregon will have three more weeks’ of data in its final enrollment numbers. State officials are working toward the modest goal of 100,000 consumers for next year, down from 130,000 consumers in 2017. The last day to select a plan for 2018 is two weeks from today, Dec. 15.

"If you haven't focused on your health insurance yet, now is the time to do it," said Chiqui Flowers, administrator of the Oregon Health Insurance Marketplace. "A licensed insurance agent or an expert from a certified community group can help you enroll, and their assistance is free."

Flowers urged consumers not to be confused by deadlines they may hear from neighboring states that still have their own health insurance websites. Oregon’s deadline, set by the Trump administration, is Dec. 15, even as the Washington Healthplanfinder stays open until Jan. 15, and Covered California is keeping its enrollment open until Jan. 31.

The latest enrollment numbers come with a big caveat -- they do not include existing consumers who are satisfied with their 2017 plan and choose to let their health plan to automatically re-enroll them for 2018, the default option for most consumers.

The final numbers would likely include a surge from these auto-renewers, but the spokeswoman for the Oregon Health Insurance Marketplace, Elizabeth Cronen, said she discourages people from auto-renewing their health plan.

“People with 2017 plans through HealthCare.gov are still encouraged to actively shop and re-enroll for 2018, because that is the best way to get the plan that works best for them, and the right amount of financial assistance for 2018,” Cronen said.

Individual health plans rose about 7 to 12 percent in 2018 compared to 2017, but consumers who have been receiving a subsidy should not see the cost of their plans increase much if their income stays the same. In fact, consumers with bronze plans and some Kaiser Permanente health plans will see their premium prices drop.

$64,000 Magic Number

For middle-class consumers above the income limit for subsidies -- about $48,000 for a single person or $64,000 for a married couple -- the Affordable Care Act, or Obamacare, has become increasingly unaffordable.

A 60-year-old couple making $70,000 could be essentially priced out of the market, as they would have to pay $21,000, or nearly 30 percent of their income, in order to purchase a silver plan on the exchange. A bronze plan is not a notably better option, costing $16,000, or 23 percent of their income, and then with a $12,000 deductible.

Dan Neils, an insurance broker at Agape Insurance in Oregon City, has suggested some solutions for reducing their gross income if it is just above the limit for subsidies and they can be flexible with their money.

Neils said that the hypothetical 60-year-old couple may be able to lower their modified adjusted gross income by $6,000, and receive an affordable plan, by either putting that money in a health savings account or a traditional Individual Retirement Account.

Lowering their income below the threshold would instantly mean getting a $13,000 annual insurance subsidy, lowering the premium cost for a silver plan to about $8,000 a year, or $667 a  month. Neils said the least expensive bronze plan for them is just $65 a month, even if they would still have a $6,550 deductible per person.

“Couples in their 50s and 60s need to understand that $64,000 is the magic number for getting a tax credit, and they can plan ethically to lower their adjusted gross income accordingly,” Neils said. “$65,000 and they get no tax credit.”

He also behooves customers to sign up through healthcare.gov and not purchase directly from the insurance company, because that's the only way to get tax credits. Even people who currently make too much money to qualify for a subsidy could have unforseen challenges in 2018 where they miss work and end up with a lower income. But if they're locked into a plan outside the exchange, they won't be able to switch to one on healthcare.gov with a potential tax credit.

"I had two people who missed out on a big tax credit because they did not sign up with healthcare.gov," Neils said.

Reach Chris Gray at chris@thelundreport.org.

Correction: The original article incorrectly stated that a consumer could reduce their adjusted gross income with a Roth IRA.

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