Two more insurance companies will offer plans to Utahns in 2020 under the Affordable Care Act, providing more options as enrollment opens this week — and, health advocates say, many will likely see a reduction in premiums.

BridgeSpan, which left Utah’s Obamacare marketplace in 2016, is rejoining, and Cigna is offering plans to Utahns for the first time.

“We’re looking at a little bit more ... variety of health plans,” said Maria Guadarrama, spokeswoman for Take Care Utah, a nonprofit that works with patients to navigate health insurance options.

More participants also could mean lower premiums, though Guadarrama said that won’t be known for sure until the enrollment period begins Friday. It runs until Dec. 15.

Enrollment has been rising slightly in Utah, with 194,570 enrollees in 2019 and 194,118 in 2018, according to federal statistics. Plans purchased through the Obamacare marketplace are for people who do not get insurance through their employer or who are not eligible for government programs, such as Medicaid.

This year brings a change: For the first time, there will be no tax penalty for going without health insurance. Previously, uninsured families were taxed $695 per adult and about $350 per child — or 2.5% of household income, whichever was greater — to incentivize coverage. That penalty ends this year; some states have implemented their own penalties, but not Utah.

It’s not clear how much that will affect enrollment, Guadarrama said. Nationwide, more than two-thirds of uninsured households obtained exemptions from the penalty anyway, the IRS reported.

Meanwhile, Guadarrama said, people who have obtained health insurance for the first time through Obamacare generally don’t want to go back to being uninsured.

“People do want to be on health insurance, and regardless of that mandatory fee, we’re still seeing numbers high for enrollment,” Guadarrama said.

It’s also unclear how Utah’s halting approach to Medicaid expansion could affect marketplace enrollment this year. In 2018, Utah voters approved expanding Medicaid to everyone earning up to 138% of the federal poverty level — the lowest income limit required to receive federal funding enhancements under the Affordable Care Act.

As a result of that initiative, some Utahns did not enroll in marketplace plans because they believed they’d be eligible for Medicaid, health advocates said.

But the state Legislature overturned the voter-passed initiative and passed in its place a partial expansion, covering only those at or below the federal poverty level. Some of those who thought they’d be covered by Medicaid no longer were, and it was too late for them to enroll in a marketplace plan. The state’s Medicaid director has said there is no way to know how many Utahns fell through that crack.

Friday is the first opportunity for those Utahns to enroll in a marketplace plan — but now it appears they may be eligible for Medicaid next year. The Trump administration refused to sign off on Utah’s partial expansion, which could usher in full expansion in 2020.

It’s not clear whether those families who found themselves without insurance will trust that Medicaid will finally cover them, or whether they will try to enroll in a marketplace plan, Guadarrama said.

Utah had 72,000 children not covered by health insurance in 2018, according to researchers from Georgetown’s Center for Children and Families. That number has grown 22% in two years.

Also unknown is the impact of legal challenges, championed by the Trump administration and Republicans, who oppose the law. For example, an appeal is pending following a Texas lawsuit in which a federal judge struck down Obamacare. The ruling is expected soon, and if the appeals court upholds the Texas ruling, people may believe marketplace plans are no longer available — even though Obamacare would remain in effect while the case undergoes further litigation.

“There is still confusion with the administration whether Obamacare is still continuing or not,” Guadarrama said. “As of right now, yes we are. We’re getting ready for open enrollment Nov. 1."

Some Utahns may also be able to sign up outside of the normal enrollment period if they experience a qualifying event, such as a change in employment or immigration status, a birth of a child, or when they turn 26 and are no longer eligible for their parents’ plan.

For help identifying a plan for your family, you can reach an enrollment specialist at takecareutah.org, Guadarrama said.