Get covered now through the reopened ACA marketplace
The pandemic reopened the Affordable Care Act marketplaces, giving millions who lack job-based coverage a chance at subsidized health plans — and many don’t even know they qualify.
1 Why Coverage Matters Now
The pandemic has obviously increased the need for more Americans to be covered by some kind of health insurance.
Not only are people of all ages being hospitalized with COVID-19, but at least 20 percent of those who contract the illness are battling long-term aftereffects (the so-called “long haulers”).
Therefore, in late January, the Biden administration ordered the reopening of the Affordable Care Act (ACA) marketplaces for three months. This will allow millions who lack job-based insurance a chance to obtain subsidized health plans.
Because many people still aren’t aware that they’re eligible, BILLSHARK wants to get the word out.
2 A Well-Kept Secret
The ACA, commonly known as “Obamacare,” opened in 2014. The health-policy research organization Kaiser Family Foundation estimates nearly 15 million uninsured people in the U.S. could qualify for ACA health plans. Of those, about nine million would be eligible for federal financial assistance to make their plans more affordable.
“There are a lot of uninsured people who even before COIVD were eligible for either hefty marketplace subsidies or for Medicaid and not aware of it,” Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms told NPR.
According to an Urban Institute Study last September, about two-thirds of uninsured Americans said they had heard nothing or only a little about financial assistance for policies.
“There are millions of people, literally, in the country who aren’t enrolled because they don’t even know they are eligible for [financial assistance],” Joel Ario, managing director of Manatt Health Solutions and a former health official in the Obama administration, told CNN.
3 Hope for Subsidies
Besides reopening the special enrollment period, President Biden’s directive also frees up $50 million. This is for increasing public awareness about the new window. Plus, it will provide federal aid for outreach and contracts with community groups that help people sign up.
Once the latest pandemic stimulus package is (hopefully!) passed, it is expected to contain additional funding for premium subsidies to help people pay for their plans.
According to calculations by the Center on Budget and Policy Priorities, which advocates on behalf of low-income people, a family of four making $50,000 would pay $67 a month in premiums if the package is enacted, as opposed to the current average of $252. They could also qualify for help with deductibles and copays.
A single person making $30,000 a year would see their monthly premium drop from $195 to $85. These subsidies would be available for this year and next.
“There’s a risk in reopening enrollment without increasing subsidies. It will be hard to get more people to sign up without the coverage being any more affordable.” — Larry Levitt, Kaiser’s executive vice president
But there’s a chance the subsidies will be included. America’s health care industry has been asking for such action since early in the pandemic. The previous administration refused to reopen the federal exchange last spring. It also refused to extend last fall’s open enrollment period beyond six weeks, and it slashed the outreach budget for the period by 90 percent.
4 What You Need to Know
The current enrollment window is between now and May 15, a period about twice as long as annual open enrollment. Remember that if you’re under age 26 you may be able to remain on your parent’s health care plan.
If you leave a job for any reason and lose job-based insurance, you can buy insurance at any time during the year, even if it’s outside the open-enrollment window. But you have only 60 days to enroll. While you may be eligible to continue your health insurance through COBRA, a plan through the ACA will likely be a lot more affordable.
Even those who lost their jobs many months ago can still sign up during this new enrollment period. The federal marketplace is open to anyone who is uninsured. In addition, if your hours have been reduced or your income has been cut back, you can go back to the federal marketplace and update your financial information. This may allow you to qualify for subsidies you couldn’t before, or even become eligible for Medicaid.
If you have income that’s hard to predict, such as gig work, you can apply with your best estimate of what you expect to make during the year. If you’re self-employed or starting a solo business with little income, you’ll probably qualify for low-cost insurance or free or low-cost coverage through Medicaid.
Even if you think you make too much money to qualify for subsidies, try applying anyway. Those with incomes up to 400 percent of the federal poverty level (about $51,500 for a single person; $104,500 for a family of four) may be eligible for assistance.
In some cases, you may qualify for Medicaid rather than having to purchase insurance through the ACA. When you go to apply, the algorithm will figure out whether your income is below the threshold for Medicaid. If so, you will be directed to your state’s Medicaid site.
For information, go to the ACA website or call 1-800-318-2596.
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Frequently Asked Questions
Why did the ACA marketplaces reopen during the pandemic?
In late January, the Biden administration ordered the reopening of the Affordable Care Act marketplaces for three months. The pandemic increased the need for coverage, with people of all ages being hospitalized with COVID-19 and at least 20 percent of those who contract the illness battling long-term aftereffects. The reopening lets millions who lack job-based insurance obtain subsidized health plans.
How many uninsured people could qualify for ACA health plans?
The Kaiser Family Foundation estimates nearly 15 million uninsured people in the U.S. could qualify for ACA health plans. Of those, about nine million would be eligible for federal financial assistance to make their plans more affordable. Many are not enrolled simply because they do not know they are eligible for that assistance.
How much could subsidies lower my monthly premium?
According to the Center on Budget and Policy Priorities, if the stimulus package is enacted, a family of four making $50,000 would pay $67 a month in premiums instead of the current average of $252, and could also get help with deductibles and copays. A single person making $30,000 a year would see their monthly premium drop from $195 to $85.
What is the enrollment window and who can sign up?
The current enrollment window runs between now and May 15, about twice as long as annual open enrollment. The federal marketplace is open to anyone who is uninsured, including those who lost jobs many months ago. If you leave a job and lose insurance you can enroll anytime, but you have only 60 days. If your hours or income were cut, you can update your information to qualify for subsidies or Medicaid.
Should I apply if I think I earn too much to qualify?
Yes, try applying anyway. Those with incomes up to 400 percent of the federal poverty level — about $51,500 for a single person or $104,500 for a family of four — may be eligible for assistance. In some cases you may qualify for Medicaid instead; the application algorithm checks whether your income is below the Medicaid threshold and directs you to your state’s Medicaid site if so.
