Open enrollment for ACA insurance exchanges to begin November 1, 2018

October 18, 2018

With open enrollment for 2019 insurance coverage set to begin on November 1, states and advocates preparing to help consumers seek the right insurance plan for them on the marketplaces authorized by the Affordable Care Act (ACA).

While 34 states (including Delaware, Maine, New Hampshire, New Jersey, and Pennsylvania) rely on the federal marketplace, six states in the ERC — Connecticut, Maryland, Massachusetts, New York, Rhode Island, and Vermont — operate their own marketplaces rather than relying on the federal insurance marketplace. Regardless of whether they operate their own marketplace, most states follow the federal open enrollment period, which will close on December 15.

woman getting vaccine

Photo by CDC on Unsplash

Although many observers have been concerned about instability in state insurance markets, the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees the ACA marketplaces and insurance plans, announced that the average premium for standard plans (the second lowest-cost “silver” plans) will drop by 1.5 percent, the first time average premiums have dropped since 2014.

However, consumer advocates are concerned about a number of factors that may reduce enrollment. First, since 2017, the open enrollment period has only been for a month and a half, shorter than the three months allowed in prior years. CMS justified shortening the period, saying it encourages consumers to buy early rather than wait until the new year to decide whether they need insurance.

Second, CMS has announced that the federal marketplace’s website,, would be offline for maintenance for up to 60 hours during open enrollment: the website will be down every Sunday between midnight and noon EST, except on December 9, the final Sunday of open enrollment. CMS has noted that this time period corresponds with periods when sees the lowest traffic. But some observers criticized the Trump administration for what they considered excessive maintenance periods meant to undermine the healthcare exchanges.

Third, CMS cut funding for healthcare navigators, or individuals and organizations who assist consumers with selecting the right plan for them via, for the second year in a row. Since 2017, the navigator program has been cut by about 84 percent to $10 million to provide funding to assist consumers in 34 states.

The ACA marketplaces were a major focus of this year’s ERC health committee sessions as part of the 2018 Annual Meeting and will continue to be an area to watch. If you have additional comments, questions, or thoughts on things to watch for our 2019 meeting in Pittsburgh, please feel free to email me.

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