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2019 ACA open enrollment has begun. Here’s what you need to know

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Families affected by pre-existing conditions attend a news conference on Capitol Hill in Washington, Tuesday, June 26, 2018. (AP Photo/Andrew Harnik)

Open enrollment has begun for those who get health insurance through the Affordable Care Act individual marketplace. Whether you’re one of the 400,000 Pennsylvanians insured through the marketplace, planning to sign up, or thinking of going without insurance this year, here’s the latest on the ACA.

Shop around

Like every year, the cost and number of plans in each county have changed for 2018-2019, said Pennsylvania Insurance Commissioner Jessica Altman. This is the first year premiums have seen an overall decrease  – 2.3 percent. People already insured through the marketplace should check to see whether there’s a lower-premium option new to their coverage area for 2019, Altman said.

Don’t wait too long

Open enrollment runs from Nov. 1 through December 15. That’s a shorter window of time than it was two years ago, and though there are some exceptions, most people won’t be able to buy individual insurance after that.

You won’t be taxed if you don’t enroll

The Trump Administration’s 2018 Tax Plan included a provision that ended the taxing power of the Affordable Care Act’s individual mandate. Health care experts are uncertain what effect this may have on the long-term stability of the marketplace. However, for now, the only effect is that people who don’t buy insurance for 2019 will not face a tax penalty. People who don’t have insurance through the end of 2018 may still get hit with the tax in the upcoming filing season, insurance commissioner Altman said.

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In this Aug. 22, 2018 photo, April Box poses for a photo at her home in Spokane, Wash. Box is a healthcare advocate and runs the website www.hip-help.com to help guide people through major surgeries and other aspects of the healthcare system. (AP Photo/Ted S. Warren)

There’s some weird insurance out there this year

Recently the Trump administration changed an Obama-era rule on short-term, limited-duration health insurance. These plans used to be limited to 90 days. Now, people can enroll in them for up to two years. Some insurers are marketing the plans as cheaper alternatives to ACA insurance. However, health insurance experts have widely derided the plans, saying theymay provide little actual coverage. Altman said people should “read the fine print” before signing up for one of these plans. She also noted that even a simple error like typing “.com” instead of “.gov” at the end of “Healthcare.gov,” the ACA enrollment website, could lead someone to a website selling plans that are not part of the ACA and don’t have to meet the standards established by it.  

Pre-existing conditions are protected – for now

Days away from the election, the discussion around pre-existing conditions has been central to the health care debate.

The rule requiring insurers to cover people who have pre-existing conditions is written into the ACA. Democrats have said a vote to repeal the ACA is the same as a vote to end protections for pre-existing conditions. Republicans pointed to recent bills they’ve proposed in Congress that would keep pre-existing conditions, However, as this recent Transforming Health report shows, University of Pennsylvania law professor Allison Hoffman said those bills wouldn’t do enough to protect people.

In addition, a lawsuit, Texas v. United States, is making its way through federal court. The lawsuit, filed by 20 Republican lawmakers and two Republican governors, aims to declare the ACA unconstitutional. That move would also end protections for pre-existing conditions, Hoffman said.

The Texas lawsuit could threaten the ACA’s future, Altman said. However, it’s not something that will be settled within the next year. For 2019, at least, the ACA is intact.