CDC Clinic Chief Nurse Lee Ann Jean-Louis extracting Influenza Virus Vaccine, Fluzone® from a 5 ml. vial. Credit: Jim Gathany / CDC

An estimated 446,000 Oklahomans can now obtain individual health plans for 2015 through the online marketplace established by the Affordable Care Act.

The 2015 open enrollment period began Saturday, Nov. 15, and ends Sunday, Feb. 15. Federal officials and ACA advocates are encouraging people to complete their applications by Dec. 15 to avoid ensure their coverage begins on Jan. 1.

A recent national survey by the Henry J. Kaiser Family Foundation in Washington, D.C., showed that 89 percent of uninsured people were not aware that open enrollment begins this month.

“It’s an unfortunate continuation of a trend that’s been going on for quite a while now,” Kaiser Foundation Senior Fellow Karen Politz said in a briefing with reporters. “People really aren’t that familiar with what’s in the ACA, whether it will help them, and what the rules are.”

Nearly 70,000 Oklahomans purchased ACA marketplace policies during 2014, the first year they were available. All of them are eligible to shop for better deals and sign up for different plans during the 2015 round.

If they don’t do so, they will be automatically re-enrolled in the same policies they now hold. Many will be subject to premium increases, which vary in amount from plan to plan.

An additional 376,000 uninsured Oklahomans who didn’t obtain coverage for 2014 are eligible to do so for 2015, according to Henry J. Kaiser Foundation estimates.

In most cases, people will use the federal government’s online marketplace to determine their eligibility and compare plan options: The toll-free help line is 1-800-318-2596. The Henry J. Kaiser Foundation has a tax credit estimator at

People who hold existing ACA policies and who aren’t interested in comparison shopping can interact directly with the private insurance companies that issued their policies. People who want assistance with sign-ups can contact government-certified navigators. People also can enlist the aid of an independent insurance agent or broker to obtain coverage, at no additional cost.

Most people are required to obtain health insurance if they don’t already have it. Those who don’t do so are subject to a fine ranging from $95 to $2,448 per adult, depending on income.

Some uninsured people will be exempt from the fines. Because Oklahoma refused to expand its Medicaid program, people below the poverty line here will not be fined. Native Americans are exempt, too.

Many, but not all, uninsured people are eligible to receive government subsidies to reduce the cost of their policies. For 2015, subsidies will be provided to single people with incomes between $11,670 and $46,680 a year, two people with incomes between $15,730 and $62,920, three people with incomes between $19,790 and $79,160, and four people with incomes between $23,850 and $95,400.

Uninsured Oklahomans who fall below those thresholds are not eligible to receive subsidies. That’s because the federal government originally intended to provide their coverage through an expansion of Medicaid. But the U.S. Supreme Court ruled that Washington could not force states to participate in Medicaid expansion. Oklahoma is one of 23 states that have chosen not to do so.

The Affordable Care Act, sometimes called Obamacare, has been under attack ever since its passage in 2010. Many congressional Republicans, buoyed by the party’s gains in this year’s elections, hope to scale it back in 2015. In addition, the U.S. Supreme Court has agreed to consider a case challenging the legality of premium subsidies in Oklahoma and other states where the federal government operates the marketplace.

Henry J. Kaiser Foundation analysts said they believe uninsured people should not wait for the outcome of those policy disputes before deciding whether to comply with the mandate for most Americans to obtain health coverage.

Congressional action on the Affordable Care Act is unlikely before the enrollment period ends on Feb. 15, they said, and the Supreme Court is not expected to issue a ruling on subsidies before next spring.

“I suppose something could change in the future,” Politz said. “But for now, the tax credits are available no matter where you live, and the obligation to have coverage applies no matter where you live.”

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