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Open enrollment, the annual period where you can sign up for plans that fall under the Affordable Care Act — also popularly called Obamacare — has started. In 2016, about 16 percent of Americans bought private individual health plans, which includes Affordable Care Act offerings sold on government exchanges, according to the U.S. Census Bureau. Every year, millions of people have to make decisions about the kind of care they need. During the 2018 annual enrollment, for example, nearly 11.8 million people signed up or were automatically enrolled through the ACA. But another choice, known as a short-term health plan, is much cheaper and designed to appeal to younger, healthier people, or people of any age who want to save money. Unlike ACA plans, you can sign up for them throughout the year. Side-by-side, these plans cost far less. A 30-year-old woman in Chicago buying an ACA "Bronze" plan, according to Shaun Greene, senior vice president of AgileHealthInsurance, would pay $219.57 per month. If she buys a short-term plan, she'd pay approximately $120. The White House earlier this month made a couple of important tweaks to short-term health plans, to increase their appeal to consumers. That's on top of ending the penalty for not buying standard health-care coverage. You can now use subsidies to purchase short-term plans, depending on your state and income level. Next year, California will no longer allow these plans to be offered. Other states have enacted limits on how many times a plan can be renewed; still other states have expanded renewals. Claire McAndrew, director of campaigns and partnerships at Families USA, an advocacy organization for health-care consumers, calls the change concerning and potentially illegal. "Federal law is very clear that those subsidies are for standard health insurance," she said. The danger is that consumers could be diverted from buying regular health insurance.

"If the plan can have a term of up to 12 months and is potentially renewable, a healthy person might not think twice about just enrolling for the full year," said Louise Norris, a writer and health insurance brokerage co-owner at Colorado Health Insurance Insider. That short-term plan might prove to be wholly inadequate in the face of a serious medical condition. "And they're still stuck with having to wait until the start of the following year before they can get coverage under an ACA-compliant plan," Norris said. Karen Pollitz senior fellow, health reform and private insurance at the Kaiser Family Foundation, says the changes will make it harder for people to see the difference between ACA plans and short-term plans. "You see the words renewable and extensions, but they are meaningless words," Pollitz said. Renewals are always up to the insurer, not the consumer. "That is why the Obama administration put those limits in place," she said. "These policies will cut out on you when you get sick."

The fine print

Buyer beware

Greene, of AgileHealthInsurance, says the plans offer consumers a choice. "All insurance is regulated, filed and reviewed by state insurance departments," Greene said. "If someone is in a short-term plan that is a bad fit, it's not junk insurance – it's the wrong plan. "People need to understand what they're buying and buy the right thing." The plans can be problematic for people who think they're going to have health issues. "If you take one and have issues, then shame on you, because you should have been on the other plan," Greene said. Policies that are compliant with the Affordable Care Act do not use underwriting. You may have heard that term used in insurance contracts – here's what it means. Insurance works best when the risk is spread out among many people. One way insurance companies manage risk is by finding out how risky it is to insure someone. For instance, young male drivers are considered to be more reckless, so they generally pay much higher rates for their car insurance. Plans that comply with ACA regulations accept everyone, no questions asked. They are more expensive because they guarantee specific benefits, like maternity care. All insurers that sell short-term plans, on the other hand, use underwriting to determine how expensive it might be to cover someone. You will have to answer questions about your personal health and habits before you're accepted. If you answer a question that means you're going to cost more, you'll get a quick turn-down, like the one shown below.

If you're planning on having a child, or use tobacco products, or have a history of diabetes or other illness, short-term health insurers likely will turn you down.

Weakening the ACA market