President Biden recently announced that he has extended the currently active special enrollment period for Affordable Care Act marketplace plans on healthcare.gov to August 15 (from a previous May 15 deadline). This is a newsworthy follow-up to a number of provisions that bolstered the ACA that were included in the recently passed American Rescue Plan Act of 2021.
The new provisions that were enacted for 2021 and 2022 are:
- Increase subsidies (premium tax credits) for everyone under 400% of the federal poverty level (FPL) in 2021 and 2022.
- Eliminate the ACA subsidy cliff for those over 400% of the FPL in 2021 and 2022. Premiums are now capped at 8.5% of income, versus no cap.
- Those receiving unemployment benefits during 2021 will have their income treated as no higher than 133% of the FPL. This will allow them to receive maximal subsidies for ACA coverage (potentially including zero-premium coverage).
These are fairly generous enhancements that haven’t gotten much press, as the $1,400 relief payments and the enhanced Child Tax Credits have received most of the attention. The ACA enhancements will make plans more affordable for those currently registered for an ACA plan and create an incentive for members to re-shop for a better plan. It also makes ACA plans more appealing for those who have not registered, including recently unemployed individuals and those whose incomes were too high to previously qualify for subsidy help.
In light of these changes, it’s also worth reiterating that there are a number of health insurance options for newly unemployed and uninsured individuals:
- You can get added to your spouse or domestic partner’s plan.
- You can keep your former employer’s health insurance through COBRA (FYI, COBRA premiums are now covered through September through another American Rescue Plan Act provision).
- You can sign up for an ACA marketplace plan on healthcare.gov or through a state healthcare exchange.
- You can sign-up for Medicaid, CHIP (for Dependent Children), or Medicare.
Outside of the ACA open enrollment period (typically the last 6 weeks of the year), the ACA requires that an individual registering have a qualifying life event in order to be eligible to register for a personal “special enrollment period”. There are many qualifying events for special enrollment outside of open enrollment, including losing employer-based health insurance (typically within 60 days).
If you do have a qualifying life event, you are eligible to enroll at any time and do not have to wait for an open enrollment period. This special enrollment period changes that – and anyone who doesn’t have qualified employer-based or other coverage is eligible to register for a new ACA plan.
There could be some variation on deadline for the residents of some states. The 36 states that use healthcare.gov for their exchange will automatically have the new August 15 deadline. The other 14 states (listed below) and DC may potentially move their deadlines to follow suit. Here are their exchange websites to check for updates.
- District of Columbia: has extended “now through the end of the pandemic”
- New Jersey
- New York
- Rhode Island
- Washington State
In the event that your state has not extended the special open enrollment deadline, you may want to start shopping for a new plan right now. And, if you currently have an ACA plan or have no plan at all, I would definitely recommend shopping