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Obamacare Texas

How To Enroll In Obamacare In Texas For 2018

Residents in the State of Texas use the the federally facilitated website at HealthCare.gov to enroll in health insurance under the Affordable Care Act because Texas did not create its own state exchange marketplace. Texans can also use an independent agent, online broker website or independent healthcare marketplace to enroll directly in a health insurance plan and still have access to the cost-saving options available to them under the Affordable Care Act (Obamacare).

You Can Use the Form Below To Get Actual Updated Price Estimates For 2018

 

Obamacare's Requirement by Law in Texas

Despite the political upheaval over the past couple of year around Obamacare and other healthcare reform efforts, it’s important to know that Obamacare is still the law of the land, which means that Obamacare’s individual mandate is still in effect and the IRS is supposed to enforce the mandate as well. This means that under the Affordable Care Act, any person who is not exempt from getting health insurance under Obamacare must enroll and keep qualifying health insurance cover for the entire calendar year or else they will face a penalty fee. For 2018, the fee is the greater of 2.5 percent of your taxable income or $695 per uninsured adult and $347.50 per uninsured child under 18. The fee is supposed to increase with inflation each year according to the law. Update: Starting in January of 2019, the tax penalty or what is also called the individual mandate, will no longer be law.

Obamacare Enrollment in Texas

Texas saw a decline in enrollments during the 2018 open enrollment period just as many other states did. In 2018, 1,126,838 Texans enrolled in a marketplace place on Healthcare.gov or another website or with an agent over the phone. During the 2017 open enrollment period, 1,227,290 people signed up for health insurance using the state exchange, compared to over 1.3 million the year prior, in 2016. The downward shift in enrollment over the past few years can be contributed to a number of factors and circumstances, including uncertainty over the current Administration’s position on Obamacare and healthcare reform and the increasing costs of monthly premiums. Despite the decrease in signups, Texas had the third highest exchange-based enrollment totals in the country. Florida had the highest enrollment numbers and California came in second.

While Texas enrollees can use the federal marketplace site for enrollment, it may be beneficial to shop around using a comparison website like this one. Getting current quotes from multiple carriers can help you find a plan that adequately addresses your medical needs and fits your family's budget. Brokers can also help explain your options more clearly.

In 2018, customers in Texas were able to choose from eight carriers on the exchange, losing two from the previous year (Humana and Prominence).

  • Ambetter (Celtic)
  • Blue Cross Blue Shield of Texas
  • CHRISTUS Health
  • Community Health Choice
  • FirstCare (SHA)
  • IdealCare (Sendero)
  • Molina
  • Oscar

Plan options from these insurers will vary across the state, but most Texans can expect to choose from one to three carriers. Two counties in the Lone Star State (Jefferson and Burnett) will have more than three insurer options. Premium rate increases for 2018 will also vary, ranging from 15 to just under 43 percent. Texas insurers have assumed that cost-sharing reduction payments will continue for 2018. If CSR payments are not guaranteed, then premiums are likely to increase even further.

 

Cost Assistance For Texas Residents

 

Many Texan families and individuals will be eligible for financial assistance to help them pay their monthly premiums and out-of-pocket costs if they are lower or middle-income (earn between 100 and 400 percent of the federal poverty level).  Approximately 83 percent of exchange customers in Texas qualified for premium subsidies in 2017. Subsidies and tax credits are available to Texans year-round; however, no one can enroll in an Obamacare plan outside of the open enrollment period unless they have a qualified life event such as they lost their employment plan, they turned 26 and can no longer be insured under their parent's plan, or they moved to a new ZIP code and their old plan is no longer offered to them in this region. If a person does have a qualified life event, they can enroll in an Obamacare plan by any means during the Special Enrollment Period, which starts on the date of the qualified life event and ends 60 days later.

The next open enrollment for 2019 starts on November 1, 2018 and ends on December 15, 2018 this year.


Texas is one of 36 states that relies on the federal health exchange (the Marketplace) for its healthcare coverage. However, in January 2015,  Texas State Representative Chris Turner, a Democrat, filed two bills designed to establish a state-run exchange. These bills, which both centered on the recent Supreme Court case (King v. Burwell), both failed. Considering that the Supreme Court ruled in favor of continuing federal subsidies, this removed much of the need for a state-run exchange.

Texas residents can turn to the federal Marketplace’s website, www.Healthcare.gov, to research and compare direct quotes from various brokers and providers, including plans offered by privately owned and for-profit companies. And, purchasing any of these policies means that you are meeting the requirements of the Patient Protection and Affordable Care Act (ACA).

Also known as Obamacare, this healthcare law requires Americans to purchase health coverage during the annual Open Enrollment Period (OEP), which runs from Nov. 1, 2015 to Jan. 31, 2016. If you miss this deadline, you may face an IRS-imposed penalty.

Texas’ impressive ACA enrollment rates

The U.S. Department of Health and Human Services (HHS), which oversees the ACA, found that 1,205,174 Texans enrolled through the Marketplace during the 2015 OEP; this is the nation’s third-highest rate. 57 percent of these enrollees are actually first-time customers.

In addition, the agency found that 146,548 people enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) during the 2015 OEP. CHIP is a federal program providing free or low-cost coverage to children and other family members. This is important, as Texas has been shown to have the highest number of Medicaid enrollments among states that haven’t expanded Medicaid.

Further evidence of Obamacare’s benefits of Obamacare for Texas residents is illustrated by the HHS’s enrollment studies. In 2014, 84 percent of all residents enrolling through the Marketplace qualified for tax credits. The HHS found that in 2014, Texans had the seventh-lowest monthly premiums among the 36 states utilizing the federal Marketplace.

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