A new deadline, rising prices and fewer options for help will greet health insurance shoppers as the Affordable Care Act's main enrolment window opens Wednesday.
Also in store: Befuddlement.
"Confusion seems to be one of the key words to describe what we're facing now," said Nicholas Moriello, a Delaware-based broker.
Among the things Moriello has found he needs to clear up with customers: That the Obama-era law still exists.
Even former President Barack Obama took to Twitter Wednesday to deliver a short video reminding people that it's time to pick coverage for next year.
The health care law has survived funding cuts and congressional repeal attempts so far. Most Americans are still required to get health insurance, and they can find plans — including some generous subsidies — through state-based marketplaces or exchanges, including HealthCare.gov .
That said, some prices have skyrocketed and choices have narrowed in many markets, in part because of political bickering over the health law.
Here's what's new, what's the same, and some important points to consider when searching for 2018 coverage.
LESS TIME TO DECIDE
The main enrolment window has been sliced in half. It starts Nov. 1 and ends Dec. 15 in most states. Last year, you had until after the holidays to sign up.
Don't wait until the last minute to shop. The search can take a few hours without assistance, and websites that process applications can slow under a deadline rush.
"It's a very delicate subject when you're dealing with someone's health and if the plan doesn't work, you're stuck with it for the next year," said Dallas-based broker Tanya Boyd.
FEWER HELPERS AVAILABLE
It may be harder to find someone willing to answer questions.
President Donald Trump's administration has slashed funding for "navigator" positions created to help people enrol. It also has ended contracts for another program that brought assistance into libraries and neighbourhoods in 18 cities.
There may even be fewer agents willing to help, because of an industry-wide move to reduce commissions.
The federal HealthCare.gov website has a "Find Local Help" button on its home page. Customers also can call 1-800-318-2596.
PRICES: EXPECT HIKES
Premiums for popular "silver" level plans are climbing an average of 34 per cent in the 39 state marketplaces that operate through HealthCare.gov, according to the consulting firm Avalere. That pushes the average monthly bill to $743 from $554 this year for single coverage for a 50-year-old shopper.
The average price for more expensive gold coverage is rising 16 per cent. Cheaper bronze plans will climb 18 per cent.
Average premiums, or the price of coverage, will climb in most markets, but the size of price changes will vary widely.
MORE FINANCIAL ASSISTANCE
Income-based tax credits are calculated based on the cost of silver plans, so those credits are expected to climb, and that will funnel more help to people, especially those with lower incomes.
In some cases, credits might climb high enough to cover the entire bill for bronze plans, which usually require customers to pay a deductible of several thousand dollars before most coverage begins.
Shoppers who make too much to qualify for tax credits could face the biggest price hikes.
Those customers should check for options outside the marketplaces, where people can still buy insurance but without tax credit help.
There, insurers in some states are expected to sell cheaper versions of the silver plans, said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, which studies health care issues.
DON'T BLOW IT OFF
The health law still requires most Americans to buy coverage that complies with the law or face a penalty that can top $1,000 depending on income.
The IRS is paying attention, said Kelley Turek of the trade group America's Health Insurance Plans. She noted that the federal agency is reminding income tax filers that it will reject or suspend any returns that don't indicate whether the taxpayer had coverage.
LIKE ALWAYS: SHOP CAREFULLY
Don't just shop based on price.
The premium is only one indicator of a health plan's affordability. There's also the deductible and co-insurance, which is the percentage of the bill a patient pays after the deductible is met.
Plans also can change the doctors and medications they cover. Check on that before you renew coverage.
This story has been corrected to show that the first name of broker Nicholas Moriello is spelled with an 'h.'