2018 MIDTERM ELECTION

Time: D H M S

UPDATE: REMINDER: Current ACA enrollees in at least 6 states will HAVE to manually re-enroll!!

I've ranted several times before about the importance of current Obamacare private policy enrollees making sure to actually visit the exchange website, shop aroundlog into your account and manually re-enroll for 2015, even if nothing has changed at your end (ie, no changes in income, dependents, residence etc).

There are many reasons NOT to auto-renew, most of which are financial in nature. The short version is, you could easily end up paying more than you thought next year by not switching (in addition to premium changes, your tax credit might drop even if your income hasn't changed due to how it's calculated), and you could pay substantially less next year if you do switch to another policy (premiums are actually dropping in many markets).

However, there's another important thing to clarify. Back in June, when the HC.gov "autorenew" policy was announced, I said:

I also question the wisdom of not requiring everyone to re-enroll each year. Obviously HHS is trying to minimize the inconvenience/hassle factor, but it seems to me that this is just going to cause even greater confusion than it would if they simply issued a blanket statement: If you enrolled via an ACA exchange, you have to renew once a year even if nothing else has changed.

I don't see doing this as a big deal; people have to renew their license plates every year even if it's for the same car, for example. They don't have to make it that complicated...just have big Yes/No radio buttons once you log in that says "Have you had any significant changes in (income, dependents, etc...provide a list) since (date of existing policy enrollment)?" If no, then you click "Save" and you're done. If yes, then you go ahead and make whatever changes are necessary.

I'm bringing this up again today at the request of a long-time supporter from Rhode Island, who says exactly the same thing:

Charles, there's one key question that I've seen conflicting answers to, which will make a big difference in the 2015 numbers: What is the default if someone who has an ACA marketplace plan in 2014 does nothing? Do you get automatically re-enrolled into the same plan, with a subsidy based on the same income that you claimed last year?...But HealthSource RI's letters to me say no, if you do not take affirmative steps to re-enroll, your coverage will stop at midnight 12/31/14.

Is this a state-by-state decision? If so, it's something you should consider adding to your spreadsheet. (One would guess that states with automatic renewal would end up with higher numbers than states that require new sign-ups each year.)

This is a huge issue, and the confusion about it may lead many people to believe (erroneously) that they do not have to do anything at all to stay on the insurance plan they have.

I'll come back to Rhode Island in a minute, but first, there are 4 states which have no choice but to require manual re-enrollment for 2015, due to their original websites being completely overhauled or scrapped outright:

  • Massachusetts threw out their old site and replaced it with an all-new platform. Since the old enrollment database can't be ported over (and was screwed up anyway), residents of the state will have to start over this year.
  • Maryland residents will be automatically renewed in their current plans if they don't do anything by 12/15...but they'll lose their tax credits if they don't do anything. Since most QHP enrollees are receiving them, this effectively still amounts to requiring manual re-enrollment in my book.
  • Nevada and Oregon threw out their sites completely and moved everything over to HealthCare.Gov. Again, the data couldn't be moved, so residents of those states have to have a do-over as well.

So, getting back to Rhode Island: The writer above is absolutely correct about Rhode Island specifically choosing to require residents to manually log in and re-enroll:

The 26,000-plus people who signed up for insurance through Rhode Island’s health exchange will have to sign up again if they want to remain insured next year, and those who do will find new plans, new prices and one new carrier.

The policy of having individuals enroll again was a deliberate choice, said Dara Chadwick, spokeswoman for the exchange, formally known as HealthSource RI.

While the exchange could have opted for automatic re-enrollment, Chadwick said officials “wanted to ensure that all Rhode Islanders made the best decision for their health-care needs by evaluating the new plans, options and prices for 2015.”

This was exactly my reasoning, and I approve of it. The problem is that now we have a situation where at least 5 states are requiring manual re-enrollments, while most of the others (HC.gov, CoveredCA, etc.) are set up for automatic renewals. Those are the only 5 I know of, but there may be others I'm missing.

However, as both the writer and myself have noted, this is gonna cause confusion. Some people will think they don't have to take any action at all and will lose their coverage. Others will keep their current policies, but will be surprised at a higher premium cost.

I would prefer it if everyone, regardless of state or exchange, was given a blanket policy: Log in and at least check off something to confirm that you understand the potential changes but choose to renew your current policy anyway. In the absence of that, all I can do is try to stress the importance of this one more time: EVERYONE should double-check to make sure you're all set for 2015 regardless of which state you're in or whether you plan on keeping the same policy or not.

UPDATE: I almost forgot about Idaho, which is a special case, in that it's the only state doing the opposite of Nevada & Oregon: ID is moving from HC.gov to their own exchange. From what I can tell, they were able to transfer the data for the 76,000 Idahoans enrolled last year over to their own system, but they caution that there may be some transfer errors, so they still strongly advise residents to log into YourHealthIdaho to make sure their info is accurate & up to date before renewing/re-enrolling their policies.