ACA Open Enrollment: More Options as Dec. 15 Deadline Nears

Foundation Communities' Kori Hattemer speaks during a press conference announcing open enrollment on Oct. 26 (Photo by John Anderson)

Just more than two weeks into the open enrollment period for health insurance on the Affordable Care Act marketplace, Foun­da­tion Communities' Prosper Centers have already helped more than 1,000 Travis County residents sign up for plans. This is the 10th year they've helped Travis County residents sign up through the marketplace – a remarkable anniversary given the lengths to which Republican elected officials and the conservative legal movement went to gut the Affordable Care Act in the years after its passage. Even in the four years that Director of Prosper Programs Kori Hattemer has worked with the organization, she's seen the marketplace expand significantly.

"The biggest change is just the increased stability in the marketplace," Hattemer said. "When I started doing this four years ago, there were half the number of insurance companies in the local marketplace ... we have more coverage now than we did in the past." She noted that the marketplace changes significantly each year, with different providers entering and exiting, which is why she advises even people who are happy with their current plans to take a look at what's available each year. Two providers left the Travis County marketplace this year, Bright and Friday, while Ascension entered it, leaving nine providers offering a total of 127 different plans.

The White House and top congressional Democrats pushed to significantly expand Medicaid coverage and lower the cost of insurance premiums through last year's Build Back Better Act, but were rebuffed. Nevertheless, the Inflation Reduc­tion Act signed earlier this year did extend financial help to people purchasing marketplace plans that was first made available in the American Rescue Plan Act. That's one positive change. Another is that in the past, when one person in a family had the option to get insurance through an employer, the entire family's eligibility for subsidies on the marketplace was based on whether that one person could afford the coverage – even though the cost can go up significantly when adding a partner or children to an employer plan. Now, the so-called "family glitch" has been fixed by a new IRS rule.

The Biden administration has invested nearly $100 million into organizations that help Americans find plans on the marketplace, and has invested in raising awareness about the open enrollment dates. That piece, Hattemer said, is critical: Once people come through the doors of a Prosper Center for a free appointment to get help navigating what she called a "really complicated" system, they almost always leave with insurance. She said that only a few dozen of the more than 1,000 clients they've seen so far this year came in and ultimately didn't enroll. "Our whole job is to give you peace of mind."

The open enrollment period ends Jan. 15, but people must sign up for a plan by Dec. 15 in order for coverage to start on the first of the year; otherwise it starts Feb. 1. This is your last chance to get covered for 2023 unless you experience a life­-altering event such as a job change, a baby, or a divorce.