TRUST ME: Do NOT let yourself be passively renewed this fall; *ACTIVELY* re-enroll for 2018.


Over the years I've repeatedly pointed out the importance of NOT simply "autorenewing" your policy. Yes, it's convenient (you don't have to do anything!), but you could be hit with a nasty pricing shock even if nothing has changed at your end (that is, even if your household size, income, etc has stayed the same). Even if your current policy is still available, due to the way APTC subsidies are calculated, you could see your financial assistance drop substantially or increase substantially from year to year...and there may be a better deal available even if there wasn't last year. ACTIVELY SHOP AROUND.

As David Anderson points out, that advice will be especially important this year, due to the CSR Silver Switcharoo/Gold Gap scenario:

Every year, all of the health wonks scream from the rooftops that it is critical that people who bought their insurance on the Exchange go and actively shop. The Exchanges would eventually automatically renew people into the same or similar coverage but that mechanism could produce significant cost shocks as the relationship of the same plan to the subsidy Benchmark could change. Actively shopping removes the surprise.

This year it is even more critical. The threat that Cost Sharing Reduction Subsidies may or may not be paid has led to insurers and states adopting three basic strategies. Some are ignoring the threat and pricing their premiums in the normal fashion. Other states may be allowing insurers to spread their CSR costs across all plans. Finally, quite a few states that Charles Gaba is tracking will allow insurers to put all of the CSR costs onto the Silver plans.

...The individual level effort is to actively shop for your own plan. You are going to get a much better deal by going to Gold if you live in a Silver Load state. Take 20 minutes and make sure that you are not buying a dominated plan.

The spreadsheet Anderson links to is incomplete and even some of the filled-in states are still a bit fuzzy, but as of this writing, here's what it looks like:

  • Alaska, Maine, North Dakota, Vermont and Washington State are pricing as if CSRs will be paid (i.e., normal pricing).
  • Alabama, Idaho*, Iowa, Louisiana, New Mexico, North Carolina, Pennsylvania and Tennessee are "Silver Loading"
  • California, Connecticut, Florida, Georgia**, Louisiana** and South Carolina are going the full "Silver Switcharoo" route

*Idaho is sort of halfway between "Silver Load" and "Silver Switcharoo"
**At least one carrier ind Georgia and Louisiana are going full "Silver Switcharoo"

I (along with Anderson and a few others) will be filling in/updating the remaining states as quickly as we can, but the bottom line is this: It's gonna be messy, but if you're eligible for subsidies at all, you could find yourself with a bit of a windfall depending on what state you live in, and many Silver enrollees may find themselves much better off with a Gold plan next year.