Open enrollment in the Affordable Care Act (ACA) marketplace opened today, despite shortened deadlines, repeal of the individual mandate, stopping cost-sharing payments, and reduced outreach and marketing for the law. And with all the noise from political talking points adding to an already complicated process, your patients might be in need of a primer on what to do this year. Here are the basics:

Where to enroll

Some states have their own exchange, and some use the federal government’s. Patients can access www.healthcare.gov, www.cuidadodesalud.gov, find their state’s page here, or call (800) 318-2596 for more info.

When to enroll

Enrollment begins November 1 (except for in California, where it began in October). However, deadlines differ in some states. The deadline for most states this year is December 15. A handful (New York, California, Massachusetts, Minnesota, Colorado) have deadlines in January. Those who wait until January to enroll should be aware that their coverage will not start until February.

What about the individual mandate?

Included in the Republican-backed tax plan signed into law last year was a repeal of the individual mandate penalty for individuals who choose not to get insurance. For the coming year, this repeal will be in effect in almost all states (Massachusetts, New Jersey, and the District of Columbia will still fine those who don’t have coverage).

Premiums

According to data from the Department of Health and Human Services, silver plan premiums are down in cost by 2%. However, most premiums have increased. According to an analysis by the Kaiser Family Foundation, regulatory changes made by the Trump Administration last year have resulted in premiums being about 16% higher than they would have been otherwise. It’s important for patients to know, however, that subsidies are still available through tax credits and cost-sharing reductions (although the current administration stopped reimbursing health insurance companies that provide these cost-sharing reductions, the law still requires insurers to reduce cost sharing for eligible consumers). According to Get America Covered, an advocacy group that aims to inform the public about ACA enrollment, about 80% of people who qualify for premium tax credits will be able to find plans that cost $50 to $100 a month.

“Light” plans

The Trump administration has relaxed rules regarding short-term, limited insurance plans and association health plans. Patients should be made aware that these limited, less regulated policies may not meet ACA criteria for “essential benefits,” cover pre-existing conditions, and cover certain conditions, such as pregnancy and mental illness, or the costs of prescription drugs.

For more information, visit www.healthcare.gov and https://getamericacovered.org, or consult this extensive list of FAQs and answers on the topic from the Kaiser Family Foundation.