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Millions of Americans were able to enroll in some sort of health insurance plan ahead of the federal deadline for doing so, but many more were left unable or unwilling to do so for various reasons. As such, those people may now face a potentially sizable fine, depending upon their income, for not having done so, and also don't have too many options left for getting some sort of coverage.

Even after the federal deadline was extended by the Obama administration, allowing more people to sign up, some Americans might have to go without coverage they buy privately until the open enrollment period begins again in November, according to a report from the New York Times. There are certain instances in which people will be able to avoid that stricture – such as if they get divorced, get married, have a child, and so on – but for the most part, those who are currently uninsured will either have to obtain coverage through an employer, or buy it through a private insurer, which experts say may not be easy.

This is essentially because the open enrollment period was built into the law to prevent people from signing up for health insurance coverage only when they get sick, the report said. Because the Patient Protection and Affordable Care Act dictates that companies cannot deny anyone coverage for preexisting conditions, there was a fear that some Americans would only try to obtain coverage if they needed it, rather than when they didn't.

Other considerations
At the same time as these exchanges are now closed for enrollment, some of the poorest Americans may still be able to enroll in Medicaid year-round, the report said. Depending upon their income levels, these people may be able to qualify in many states, but not all of states expanded their Medicaid programs as was originally hoped. As such, some Americans might find that they actually fall into what are known as coverage gaps, in which they are too poor to be able to afford private coverage (or qualify for subsidized plans through the exchanges), but make too much to gain access to their states' Medicaid options.

Insurance companies might want to keep a close eye on how people who fall into these coverage gaps end up moving. If they have an increasing appetite for coverage as the year goes on, those companies that are able to help them find the most affordable coverage possible might end up seeing more business overall.