Today is kinda-sorta the deadline to sign up for Obamacare, though if you want to say you’re “in line” for coverage, the administration is okay with that. (If your state is running its own Obamacare exchange, it may be keeping its deadline firm, so check with your state.)
When we wrote about the Obamacare deadline and penalty recently, a reader brought up a great question: Can you still buy health insurance after March 31?
She asked, “If I chose to go uninsured, but end up with a massive medical issue,” could she “just buy insurance and be covered, you know, since they must cover pre-existing conditions”?
The answer is yes. If you don’t have Obamacare-compliant health insurance by today, you could pay the penalty for this year—depending on the amount of flexibility the administration decides to offer in its latest delay—or you could still purchase a policy anytime in the individual market outside the Obamacare exchanges. The amount of time you go without coverage determines your penalty—or as the IRS calls it, your “shared responsibility payment.”
Under Obamacare, the new pre-existing conditions rule means that you can wait until you develop a health problem to get your policy. This isn’t great for the system, because healthy people’s premiums are needed to pay for the sick people. So if fewer healthy people buy health insurance, the system has a problem.
That’s why the Obamacare system has a mandate forcing everyone to buy insurance, a (somewhat) set enrollment period, and a financial penalty to back it up.
If you don’t already have employer-sponsored insurance or coverage through a government health program, your options are the Obamacare exchange or the individual marketplace. Policies in both have to comply with all of Obamacare’s rules and benefit mandates, so the big difference is the taxpayer-funded subsidies.
The subsidies are supposed to be the big draw of the Obamacare exchanges—but it turns out they aren’t as simple as they seem. And holding onto a subsidy can encourage people to stay stagnant in a job—or worse, not seek employment. As Heritage experts have explained and the Congressional Budget Office has confirmed, “The law gives millions of Americans new incentives not to work—or not to raise their income levels—because they may lose federal insurance subsidies.”
Today’s deadline marks the end of the open enrollment period to buy subsidized coverage in the exchange. Enrollment for subsidized coverage doesn’t officially start again until November 15 of this year.
As we’ve noted, however, there are now quite a few ways you can qualify for an exemption from the individual mandate, in addition to the new box you can supposedly check on HealthCare.gov to indicate that you need more time to sign up.
Whether it’s your state or the federal government running your nearest Obamacare exchange, the goal remains the same. Heritage experts Robert Moffit and Ed Haislmaier described the transition from the old individual market to “private coverage in name only”:
The primary goal of the Obamacare exchanges is to establish federal control over state health insurance markets by enforcing new federal insurance rules and requiring federal standardization of health benefits.
And policies in the remaining individual market must, by law, look exactly the same. You can buy them anytime, but the benefit design isn’t likely to be much different. (Just watch how long you go without coverage, or the penalty for being uninsured will kick in.) Obamacare doesn’t improve on the old health insurance market—which is why we need patient-centered reforms that give people more choice.
This article was originally published at Heritage.org. Used with permission.