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Obamacare Indiana

Updated on May 21, 2018

Indianians use Healthcare.gov to enroll in marketplace plans, or they can enlist the help of a licensed agent or apply on their own on an independent online broker's website to get an Obamacare plan. It may be beneficial to review the plans available to you online first and then speak to a licensed agent to make sure you fully understand all of the pros and cons of a particular plan. For the 2019 calendar year, open enrollment begins on November 1, 2018 and ends on December 15, 2018. If you do want to speak to a licensed health insurance agent about your plan options, you should do so earlier in the season because the later it gets, the busier the phone lines get and there's a good chance you could wait on hold for a substantial period of time. If you feel confident in completing the process online, be aware that because Indiana uses the federal marketplace, there's a chance that you'll have to complete a portion of your application on Healthcare.gov even if you are shopping and enrolling on a website ran by an independent online broker. For instance, in years past, consumers would have to go from the independent online broker's website to Healthcare.gov to verify their identity and income before going back to the original website to sign and pay for their first month's premium.

Requirement by Law

In December 2017, Congress passed a tax bill that included a provision to remove the individual mandate starting in 2019. This means that any person who goes with Obamacare in the 2019 calendar year, will not be penalized. Until then, the individual mandate is technically still in effect and you could be penalized if you are without insurance. For the 2017 and 2018 calendar year, the penalty will be approximately 2.5 percent of your household’s taxable income or a$695 per adult and $347.50 per uninsured child (person under under 18), whichever is greater.

Enrollment in Indiana

In 2017, almost 175,000 people enrolled in an on exchange plan, which means they received a subsidy towards their total monthly premium amount. In 2018, the number decreased to a little more than 165,000, which represents a 4.5% decrease for the state.

The 2017 open enrollment period also saw a decrease of marketplace enrollments from the prior year of approximately 9%. In 2016-2017, the election played a big part in whether people were motivated to enroll in health insurance during the open enrollment period. There was a lot of uncertainty about whether Obamacare would remain the law of the land and whether people would have to enroll in health insurance.

While Indiana customers can use the federal marketplace on Healthcare.gov to enroll in health insurance, they can also shop through a comparison website so they can make sure that they are seeing all of the different plans offered in the State of Indiana. If an Indianian needs health insurance outside of the open enrollment period they will need to make sure they have a qualified life event and if they do, that they enroll within 60 days of that event occurring. CMS passed a rule in 2017 that made it more difficult to enroll in an Obamacare plan outside of the open enrollment period so be aware that your application may be stalled until you provide documented proof of your qualified life event.

In 2018, Indiana customers were able to choose from two carriers on the exchange, which was down from four carriers in 2017. The remaining carriers are CareSource and Ambetter (Celtic). Anthem and MDWise, two major insurers in the state, are exited the market, which impacted nearly 77,000 Indiana customers. Those with plans from these insurers will need to find new coverage for the coming year. There has been no news regarding how many carriers will participate in the marketplace in Indiana in 2019. That information will come out over the summer and fall of 2018.

Coverage from these insurers will vary across the state. Premium rates increased for 2018 as well and varied between from 2.2 percent (CareSource) to 24 percent (Ambetter/Celtic), with a weighted average of about 7.7 percent. It's also unknown right now what the premium increase will look like for 2019.

Cost Assistance

For Indianians earning between 100 percent and 400 percent of the federal poverty level, which is between $24,600 and $98,400 for a family of four, there is financial assistance available in the form of subsidies. These subsidies are paid by the federal government to the carrier and you are billed for the remaining balance every month. These subsidies allow lower-earning families to have access to better plans that they would otherwise not be able to afford.   Approximately 73 percent of customers in Indiana qualified for premium subsidies in 2017.

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On January 1, 2014, the Patient Protection and Affordable Care Act (later shortened to the ACA) took effect, providing Americans with high-quality health coverage. Also known as Obamacare, this healthcare law has changed the lives of millions of people.

However, individual states were given the opportunity to either create and maintain their own health exchange or let the government handle all of the responsibilities.

Indiana, along with 26 other states, relies on the federally facilitated health Marketplace. According to the U.S. Department of Health and Human Services (HHS), which oversees the ACA, 218,617 qualified health plans (QHPs) were purchased in 2015. This represents 43 percent of all of Indiana's eligible residents.

A side-by-side comparison of coverage options

But you should know that the Marketplace is not insurance. Rather, it only provides the options for different insurance providers and plans, including both private and publicly held, for-profit options. You can click on the Healthcare.gov website to research multiple policies. This provides beneficiaries with a comparison of the current prices and benefits available.

However, under the ACA's provisions, you must purchase coverage during the Open Enrollment Period (OEP). If not, you could face a penalty imposed by the IRS. The OEP runs from November 1, 2015, through Jan. 31, 2016.

And for lower- and middle-income Indiana families and individuals, the healthcare law does offer financial assistance, including tax credits and subsidies. In 2015, research shows that a total of $552 million in premium subsidies were allotted; that represents 87.4 percent of the state's residents. These subsides average $315 per month.

You can use the links below to get quotes direct from national insurance providers.

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