Obamacare Triggers Open Enrollment: The Big Health Insurance Deal No One's Talking About

February 05, 2013

I should have known it would be like this. The insurance agent in me shouldn’t have expected anything less. Of course all individual health insurance plans were going to operate on an open enrollment schedule when “Obamacare” officially lands in 2014. It’s the only way the new system could work without imploding.

For some reason I still couldn't believe it when I finally received confirmation last week during a meeting with an Anthem representative.

Why Was I Surprised?

I thought open enrollment would run in stark contrast to everything the Affordable Care Act stood for. Only being able to purchase health insurance coverage during a specific time frame would create just as many problems as it was trying to solve.

Not to mention, I thought the individual mandate, tax, responsibility or whatever they are calling it was suppose to be the mechanism that kept the system in check. The government refused to allow such a stipulation during their first go around with unfiltered coverage, when they ordered all children under 19 years old be accepted for health insurance, no questions, no time tables.

To be honest, with this new or official development, I’m not quite sure what purpose the mandate servers now. More on that in a bit.

This Is Going to be Interesting

Radically altering the availability of health insurance and when you can and cannot purchase it, is going to create a lot of problems for you. Well, maybe not YOU because you are reading this article and will have plenty of advance notice. However, it will create, dare I say, mass confusion with a majority of people who do not stay up-to-date on health insurance news.

It has been hard enough to get people to know exactly when “Obamacare” kicks in. Now we need to inform people that they will only have a specific amount of time during the year to buy health insurance?

What is Open Enrollment?

This is a fancy insurance term that indicates the time period you have to get on or off the health insurance train. Those who have been covered on plans through work have probably heard this phrase once or twice.

Once a year, during your “open enrollment” period, you have the option to modify, add or drop your coverage. Whatever decision you make will be one you have to live with for the entire year until your open enrollment period comes around again, unless there is a qualifying event.

What’s a Qualifying Event?

This is another fancy insurance term that basically means exception. If something happens that is considered an exception to the rule like getting married, losing your job or having a baby. These types of events will allow you the ability to alter your coverage outside of your open enrollment period.

When Does It Start?

Open enrollment will start in October of this year and run through March 2014. The insurance companies are throwing you a three month bone the first year in hopes word spreads fast enough that there is no one left out in the cold on April 1st. Unless it’s just an elaborate April fools joke the government, insurance companies and IRS got together on?

What About Next Year?

Next year they are going to tighten the belt and cut the enrollment period in half. That means you will only have from October to December to make any changes to your coverage or buy it if don't have it.

Why is This a Problem?

According to a report from CNN, 49.9 million Americans were uninsured in 2010 or 16.3% of the total population. It would stand to reason that a majority of those 49.9 million people are the ones who will be seeking coverage in 2014. However, they are also the people who are probably not working with an independent agent and have no reliable source to inform them of this newly created window.

If I pulled out my crystal ball for a moment, I would see 49.9 million people just starting to look for coverage on or after January 1, 2014, essentially cutting their enrollment period down to two months.

To put it nicely, that will be a mess.

What Happens if You Keep Your Current Plan?

If you purchased your plan before March 23, 2010 and have not made any changes to it, it should have maintained its grandfathered status and will continue on its normal renewal and increase cycle. I will stress the “it should” portion of that statement, since it’s not impossible for insurance companies to try and nudge their grandfathered plans over to magically merge with the new health care reform system.

What Were You Saying About the Individual Mandate Tax?

Yes, thanks for reminding me. Attaching a financial incentive is a great way to motivate people one way or the other to do just about anything, however, now that open enrollment is officially a part of the health care reform process, it greatly diminishes it’s overall need.

Now that you will be unable to purchase insurance in the ambulance on your way to the hospital, that prospect alone provides all the incentive people should need to carry health insurance. That means our constitution was trampled on for a backdoor government fundraiser.

My political conspiracy theroies aside, open enrollment is the ultimate, and prefered motivator, at least for insurance companies to get you to "pay into the system" and carry health insurance.

I Need To Ask You a Favor...

If you have a friend who is one of the 49.9 million uninsured, please share this article with them. They will be grateful you took the time to make sure they have enough time to get proper health insurance.

If you are still feeling generous after that, I would love for you to leave a comment letting me know what you think about open enrollment? Is this time frame to limiting? Will it have a negative effect on your health insurance?