Obamacare and open enrolment - what to do after it closes?

[jacob]

I have never understood the purpose of Open Enrolment which limits the change of health insurance plans to a short period each year and shuts out(?) changes for the rest of the year except for "qualifying life events" such as relocating to a new state, getting divorced, married or having children.

It seems that Obamacare features open enrolment.

So here's my question. Suppose someone is current covered by employer-based health insurance and then quit their job OUTSIDE of Obamacare's open enrolment period. If they can not enrol, they can not get covered, and as such they will get penalized by additional taxes?

Can this really be the case? Will former employees be forced into ueberexpensive COBRA plans? Or does changing job status also qualify as a "life event"?

[Tyler9000]

Good question.

The enrollment periods (AFAIK) are to keep people from maintaining the lowest cost coverage and switching to better coverage the day before visiting the doctor.

My assumption is that if you lose health coverage by leaving your job, that surely must count as a "qualifying life event" just as it does when your spouse loses coverage or you have a new child outside of your current employer's normal enrollment period.

Then again, one should not assume that a federal system is written rationally. I've also wondered if they'll force you into COBRA for a time. I've found limited info on this so far and would also appreciate if someone has a solid answer.

[Freedom_2018]

@jacob: See 2nd question http://www.washingtonpost.com/blogs/won ... 2-answers/

[jacob]

@Freedom_2018 - Thanks!!

Oh how I wish we had a single payer system in which the above would be reduced to
Q: Where can I find the nearest doctor?
A: See the phone book.

Oh well ...

[jennypenny]

@jacob: See 2nd question http://www.washingtonpost.com/blogs/won ... 2-answers/

Read the COBRA question about half way down the page, and the two articles embedded in the answer. I'm not sure if job loss is treated as the same type of 'event' as leaving your job. It looks like...
--Once you sign up for COBRA, you have to wait for open enrollment to switch.
--You can use the exchanges if the COBRA you're offered is more than 9.5% of your income. (what number are they using for that?)
--To make it work, you have to make sure your income is low enough to pass the 9.5% threshold, but high enough that you don't get dumped into medicaid.
--I think you have to factor in your spouse's income.

[Freedom_2018]

Which kind of leads to the issue I posed in my "Practical Obamacare/Medicaid Question" thread. Ah..the circle of life.

My own situation was:

- Engineered my own layoff (not so easy I tell ya) in Nov 2012
- Covered by employer on subsidized insurance till august 2013
- In preparation of layoff I had switched to the Cadillac health plan in the open enrollment period in 2011. My cost was $135/month to cover everything.
- Went and saw all kinds of doctors and did tests in 2012 for very little cost due to Cadillac plan to rule out any major issue in the next few years when I might be on a lower coverage plan paid by self (did not know then what would come out of Obamacare)
- After august my plan would have cost me $700/month on unsubsidized COBRA and they could not switch me to lower plan since it wasn't open enrollment. So switched to a $162/month bronze type plan with HealthNet. Currently on this.
- Will switch to Obamacare in Jan for much lower premiums

In case any of this helps with your job transition.

[llorona]

@Jacob: Nothing says people have to buy health insurance through the exchanges, at least not in California. As far as I can tell, the exchanges don't benefit anyone unless they're under 400% of the federal poverty level. If someone were to quit their job, they could simply find a health insurance provider and directly enroll, while bypassing the exchange. Again, this assumes their household income exceeds the 400% poverty threshold.

@JennyPenny: The income percentages are based on modified adjusted gross income (MAGI). And, yes, MAGI is based on household income, even if married folks file their taxes separately.

[KevinW]

I have never understood the purpose of Open Enrolment which limits the change of health insurance plans to a short period each year and shuts out(?) changes for the rest of the year except for "qualifying life events" such as relocating to a new state, getting divorced, married or having children.

I think the purpose is to mitigate a free rider sort of problem wherein someone with a foreseeable expensive procedure, like a child birth or shoulder surgery they've been putting off, gets primo coverage for one month to cover that procedure and then immediately downgrades to something cheap.