Will I Be Able to Get Health Insurance on the Exchange for 2018?

by Nancy Metcalf Health Writer

No matter where you live, marketplace health insurance will almost certainly be offered for 2018 — but we won’t know for sure until the end of the month.

Here’s the current situation: The Affordable Care Act is still fully in effect and the marketplaces will hold open enrollment from Nov. 1 through Dec. 15 (this is a smaller window than in previous years. The law’s system of subsidies and mandates is unchanged.

However, many health insurance companies have been skittish about participating in the marketplace in 2018, mainly because of uncertainty over whether the federal government will reimburse them for the billions the ACA requires them to spend to reduce out-of-pocket costs for their lowest-income subscribers.

The government has been sending these so-called cost-sharing reduction payments on a month-to-month basis but has thus far not committed to continuing them indefinitely.

“A lot of insurers are leaving the market,” says Louise Norris, a Colorado insurance broker and expert on the national market. “So the plans available when you shopped last year might not be the same this year.”

Every county in U.S. will offer insurance

For a while this past summer, it seemed that dozens of counties would be “bare,” without a single marketplace insurer offering 2018 plans, but as of this date, every county will have at least one. Still, a record number of counties will offer only a single carrier. But other states, such as California, Massachusetts, and New York, will offer plans from multiple carriers.

The situation remains fluid as insurers continue to exit or enter the 2018 market, so “it’s not over until insurers sign contracts in late September,” says Jo Ann Volk, who tracks the commercial insurance market for the Georgetown University Center on Health Insurance Reform.

If your 2017 carrier is withdrawing from your state’s exchange, you’ll be notified in plenty of time to select a different plan. “Read any communication that comes from your plan or exchange,” advises Norris. “Don’t assume it’s junk mail.”

To monitor the situation in your own locale, check this interactive map from the nonprofit, nonpartisan Kaiser Family Foundation, and Norris’ state-by-state updates.

What’s up regarding rate hikes

Because health insurers have to pay the cost-sharing reductions even if they don’t get reimbursed for them, state regulators are allowing them to build the extra money into their rate requests.

In California, for instance, insurers have asked for an average 12.5 percent rate request for 2018 if they get the reimbursements, but will raise rates by double that if the reimbursements aren’t forthcoming.

Consumers who qualify for premium subsidies will be protected from these rate increases, but those who don’t will bear the full brunt of them.

Nancy Metcalf
Meet Our Writer
Nancy Metcalf

Nancy Metcalf is an award-winning independent journalist specializing in health topics. A senior writer and editor for Consumer Reports for more than 25 years, she is a nationally recognized expert on health insurance and health reform.