The Affordable Care Act (ACA; aka Obamacare) Health Insurance Marketplace begins its fifth Open Enrollment period today. American healthcare consumers can sign up on the federal insurance exchange at healthcare.gov or through their state marketplaces. This year, there is increased confusion and anxiety surrounding Open Enrollment due to changes (and attempted changes) made to the ACA under the Trump administration.

Previous years Open Enrollment period ran 90 days after November 1 until the end of January but has been cut to 45 days this year unless you qualify for the Special Enrollment Period, extending the enrollment period by an additional 60 days. Further limiting access to enrollment, the healthcare.gov website has scheduled weekly 12-hour maintenance outages. Advertisements encouraging public awareness in Open Enrollment are also cut, with some allocated funds being used for an anti-ACA ad campaign, and federal health representatives have been told not to engage in outreach to help more people access enrollment.

There is also considerable confusion, with many Americans being unsure as to the