Q. What’s the current status of the Affordable Care Act?


Despite the unsuccessful attempts to repeal the Affordable Care Act (ACA), the Open Enrollment period begins November 1. Premium assistance and cost sharing reductions are still in place, although there is no longer a federal penalty for being uninsured. However, in some states you must be insured or pay a fine on your tax return. They include New Jersey, California, Washington DC, Rhode Island, Vermont, and Massachusetts.

What to look for:

  • Pay attention to the open enrollment period in your state. Open enrollment begins November 1 across the country and has been shortened to end on December 15 in most states. New York and California have extended the deadline until January 31, 2020; other states vary.

  • If you have insurance through the ACA, check your health insurance provider to make sure they will continue to offer plans in 2020. Also, check with your medical providers and billing department to determine which Marketplace health insurance plans they will be accepting in 2020.

  • Plans purchased through your state Marketplace have to abide by ACA regulations, including the right to coverage of pre-existing conditions and coverage of 10 Essential Benefits, such as hospitalization, medications, and mental health services. Short-term plans, association plans, and religious cost-sharing plans do not have to abide by these regulations. Please read your summary of benefits carefully before you choose to purchase one of these plans.

How to protect yourself:

  • Shop around! If renewing, you should be aware of alternatives in case you need to switch to a different plan. Make sure to calculate the monthly premium costs and compare them with the out-of-pocket expenses you estimate for 2020 based on the different metal tier levels.
  • Advocate for yourself. Contact your elected officials and tell them why protecting the ACA and stabilizing the insurance market are important to you.
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