ACA Individual Health Insurance Forecast for 2018

LENOIR, NC (November 12, 2017)…Open enrollment for Individual Health insurance has cranked up and is underway.  If you’re planning to sign up for an Affordable Care Act plan, you’re probably a little bit anxious, maybe confused.

Recent efforts to repeal or replace the ACA failed.  Currently the Tax Reform efforts may fold in another attempt to repeal the health care law’s individual mandate – the mandate that requires you to carry health insurance or pay a fine unless you qualify for a hardship exemption.

Even with less advertising and grants cut in half for ACA “Navigators,” health insurance plans and other coverage options are still available for 2018.  In North Carolina, every county has at least one option for individual health plans.  Under ACA law, insurers must offer at least one Silver and Gold plan and many also offer options from the other two metal tiers:  Bronze and Platinum.  Metal categories differ with Bronze and Silver plans offering the lowers monthly premiums.  You should carefully consider your choices.

Even though Navigator funding was cut back you can still get help by searching by City and State or by Zip Code on the Marketplace website, or check your local papers or phone book for insurance agents in your area.

The subsidies are still on the exchange and many still do get subsidies to reduce premiums.  Those who choose a Silver option may get additional help to cover other out of pocket costs like a reduced doctor copay or deductible.  Those are called Cost Sharing Reductions (CSRs) and that’s what the current Administration cut, not the subsidies aka Advanced Premium Tax Credits.  Companies must keep offering these Silver plans with CSRs, but they won’t receive cost sharing payments from the government.

Under the ACA, the penalty for not buying insurance still exists.  People must sign up for health insurance or pay a penalty.  The mandate will still be enforced.

To be realistic, the Marketplace still has issues with some people being ineligible for a premium subsidy or Advanced Tax Credit, some people being unable to qualify for Medicaid, and some being unable to keep their original plan they had before the ACA.  Many grandfathered individual health plans are being discontinued in this state at the end of the year.  Still there are choices for comprehensive health for individuals who lack job-based health insurance options, who don’t qualify for Medicare, Medicaid or VA benefits, or who are losing their grandfathered individual health plans.

It’s important to keep in mind that the enrollment period has been shortened:  November 1st – December 15th.   There are circumstances for Special Enrollments (moving, marriage, divorce, loss of health coverage from a job, loss of COBRA, loss of Medicaid, etc.) where enrollment can be made outside of the Annual Enrollment Period.

It’s important to also keep in mind that the Marketplace and coverage options, however, still exist.  The time is now for you to see what your coverage choices are for 2018.

~Laura Sedlacek is an Individual Health insurance Agent with Bush and Associates in Lenoir, NC.  She has been offering ACA individual health plans since they began in 2013.  Contact Laura at (828) 754-2601,, or by logging onto: or