Obamacare Enrollment Extensions -- What Happens if You Missed the Deadline?

The initial Obamacare sign-up deadline has passed, but federal and state extensions are allowing a bit more leeway for some. We look at a list of the new dates, the rules for them, and the consequences of not being insured for the remainder of the year.

Apr 11, 2014 at 6:30PM

It certainly didn't go off without a hitch.

The deadline to sign up for health insurance under the Affordable Care Act came and went on March 31, but enrollment websites crashed, marketplace phone lines groaned, and waiting times stretched on and on. Some made it through, securing approved health care plans, but some did not.

While the campaign to get 7 million Americans signed up for insurance via the federal HealthCare.gov exchange may have hit its stated mark -- and many more applicants used state exchanges to add their names to the rolls of the insured -- others have yet to successfully comply with the new health insurance mandate (or even begin the process).

Now, for the millions who remain uninsured in the U.S., consequences loom. Some may be eligible for extensions or even exemptions, but only under certain circumstances. In light of these facts, let's look at scenarios for extensions and consequences under the ACA.

ACA extensions: second chances
For some, it was as if they had waited in line to get into a new restaurant, finally gotten a table, and then been told by the waiter that the kitchen was closed. Still, if you were caught in a HealthCare.gov or state-exchange holdup because you couldn't access overloaded exchanges, you may have a second chance coming.

The new federal deadline -- a special enrollment period – already allowed registrations delayed by exchange-related problems to be finished as late as April 30 for those who submitted a paper application by April 7. That extension applied to individuals living in states where insurance enrollment under the Affordable Care Act is conducted through the federal exchange.

But other extensions are also available in states with their own exchanges, as well as in the District of Columbia. In each case, individuals must have started their application before midnight on March 31. What follow are new dates, as compiled by HealthPocket.

  • California: April 15
  • Colorado: May 31
  • Kentucky: April 15
  • Maryland: May 1
  • Massachusetts: April 15 (in special cases, June 30)
  • Minnesota: May 1
  • Nevada: May 30
  • New York: April 15
  • District of Columbia: April 15

In a number of other states, officials have promised an extension but not specified a new deadline. Others are responding to the logjam by creating a one-on-one special assistance period, supplying consultants to help the individual directly. The states falling into these two categories are Connecticut, Hawaii, Oregon, Rhode Island, Vermont, and Washington. 

There are exceptions to the ACA enrollment window for "qualifying" events during the period in which enrollment is closed. These include moving, getting married or divorced, and losing your group coverage. Under such circumstances, you should be able to acquire new ACA-compliant insurance under the terms of the law.

There are also a variety of outright exemptions to the ACA's mandate for individuals. These include religious and tribal reasons, qualifying life events and financial hardships, and Medicaid ineligibility owing to a state's refusal to expand that system.

Enrollment and fines: before the next window opens
What happens if you missed the March 31 deadline, you don't qualify for an exemption, and you fail even to meet the extensions?

  • The federal law imposes an annual penalty of $95 upon the individual. The penalty for unenrolled children is $47.50 per child, with a cap set at either $285 per family or 1% of income, whichever is higher.
  • Fees increase in 2015 to $325 per adult and $162.50 per child (up to $975 per family) or 2% of family income, whichever is greater.
  • In 2016, the penalties rise to $695 per adult and $347.50 per child (up to $2,085 per family) or 2.5% of family income, whichever is greater.

Penalties get folded into tax returns filed for the year in which they are incurred. And these fines only kick in, starting this year, if you go for three months or more without a minimum of ACA-compliant insurance.

A potential complication, however, is that if you don't enroll by the final deadlines of the extensions, insurance companies don't have to sell you compliant coverage until the next open-enrollment period begins -- the next window is scheduled to open on Nov. 15.

Granted, you might be able to purchase noncompliant insurance, but you'll likely still be exposed to the tax penalties for that year. That's still a better scenario, however, than facing the financial consequences of an illness or injury without coverage, which could wipe out savings and cripple your household.

Foolish takeaway: changes in the states
Even in states that worked to support the ACA, setting up exchanges to facilitate the process, insurance officials and agents are seeing the law impact their clients in some adverse ways.

Take Connecticut, for example, where Kevin Murray, an agent at the HIQS Group, works to link residents and multiple insurance carriers. On the one hand, the ACA guarantees that individuals will not be turned away at the insurance desk because of a pre-existing health condition. On the other hand, if they have a pre-existing condition but failed to meet the deadlines, there's little Murray can do until the window reopens.

Murray explains: "Prior to ACA, if one came to us with a pre-existing condition, we were able to procure them health insurance by either enrolling the self-employed individual in a 'group of one' -- as new groups were not subject to pre-existing exclusions -- or we could enroll them in the State of Connecticut Charter Oak program for the uninsured."

But now, according to Murray, the enrollment-window rules supersede such workarounds: "ACA has done away with these two safety nets, reducing those options for our clients."

Getting more people insured is a goal of the Affordable Care Act, and it's a good one overall, but in some cases the new federal rules limit which states have been able to help individuals facing the kind of health care challenges Murray describes. It will be a test of the law to solve those problems so individuals in extraordinary need still get insured -- even if they've made problematic choices in the run-up to their crisis.

3 stocks poised to be multi-baggers
The one sure way to get wealthy is to invest in a groundbreaking company that goes on to dominate a multibillion-dollar industry. Our analysts have found multi-bagger stocks time and again. And now they think they've done it again with three stock picks that they believe could generate the same type of phenomenal returns. They've revealed these picks in a new free report that you can download instantly by clicking here now.

Try any of our Foolish newsletter services free for 30 days. We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

James O'Brien is a contributor to WiserAdvisor.

4 in 5 Americans Are Ignoring Buffett's Warning

Don't be one of them.

Jun 12, 2015 at 5:01PM

Admitting fear is difficult.

So you can imagine how shocked I was to find out Warren Buffett recently told a select number of investors about the cutting-edge technology that's keeping him awake at night.

This past May, The Motley Fool sent 8 of its best stock analysts to Omaha, Nebraska to attend the Berkshire Hathaway annual shareholder meeting. CEO Warren Buffett and Vice Chairman Charlie Munger fielded questions for nearly 6 hours.
The catch was: Attendees weren't allowed to record any of it. No audio. No video. 

Our team of analysts wrote down every single word Buffett and Munger uttered. Over 16,000 words. But only two words stood out to me as I read the detailed transcript of the event: "Real threat."

That's how Buffett responded when asked about this emerging market that is already expected to be worth more than $2 trillion in the U.S. alone. Google has already put some of its best engineers behind the technology powering this trend. 

The amazing thing is, while Buffett may be nervous, the rest of us can invest in this new industry BEFORE the old money realizes what hit them.

KPMG advises we're "on the cusp of revolutionary change" coming much "sooner than you think."

Even one legendary MIT professor had to recant his position that the technology was "beyond the capability of computer science." (He recently confessed to The Wall Street Journal that he's now a believer and amazed "how quickly this technology caught on.")

Yet according to one J.D. Power and Associates survey, only 1 in 5 Americans are even interested in this technology, much less ready to invest in it. Needless to say, you haven't missed your window of opportunity. 

Think about how many amazing technologies you've watched soar to new heights while you kick yourself thinking, "I knew about that technology before everyone was talking about it, but I just sat on my hands." 

Don't let that happen again. This time, it should be your family telling you, "I can't believe you knew about and invested in that technology so early on."

That's why I hope you take just a few minutes to access the exclusive research our team of analysts has put together on this industry and the one stock positioned to capitalize on this major shift.

Click here to learn about this incredible technology before Buffett stops being scared and starts buying!

David Hanson owns shares of Berkshire Hathaway and American Express. The Motley Fool recommends and owns shares of Berkshire Hathaway, Google, and Coca-Cola.We Fools don't all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

©1995-2014 The Motley Fool. All rights reserved. | Privacy/Legal Information