Time to choose insurance and time protected by it are different human interests. CMS brought them together in its February 17, 2017 proposal to close enrollment for 2018 Exchange plans on December 15, 2017. The existing calendar extended through January 31, 2018. The proposed earlier finish aimed at January coverage starts, not at shortening the insurance year. [2017-03027][2016-04439]

The March 2016 final rule makes the distinction tangible. People selecting by December 15 had a January 1 coverage effective date; later selection periods led to February or March starts. That rule already scheduled a shorter enrollment window for benefit years 2019 and beyond. Bringing it forward to 2018 would trade some selection time for a calendar organized around the beginning of the benefit year. [2017-03027][2016-04439]

An ethical reading must take both the aim and the possible exclusion seriously. CMS intended extensive outreach, but its impact analysis said inadequate support for Exchanges and enrollment assisters could produce longer waits and enrollment losses. It also acknowledged potential loss of younger, healthier late enrollees, even while expecting less adverse selection. Neither a beneficial intention nor a possible harm establishes the eventual result. [2017-03027]

Our judgment is that meaningful choice depends on more than announcing a closing date: the assistance available within that period matters too. Extra outreach could carry costs for government and insurers, a constraint the proposal recognized. That is a practical tension between access and administrative resources, not a claim that any faith tradition endorses one calendar. The official baseline and proposal document the choice facing policymakers, without resolving it through later outcomes. [2017-03027][2016-04439]

Source documents

  1. Patient Protection and Affordable Care Act; Market Stabilizationhttps://www.govinfo.gov/content/pkg/FR-2017-02-17/html/2017-03027.htm
  2. Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017https://www.govinfo.gov/content/pkg/FR-2016-03-08/html/2016-04439.htm