The nation’s 10th annual open enrollment period to sign up for Affordable Care Act health insurance coverage is open from Nov. 1 through Jan. 15, and this year it includes several changes around access and affordability.
This could be the largest enrollment period yet
The number of individuals enrolled in Affordable Care Act (ACA) plans reached a record 13.8 million in 2022, with 12.5 million of those receiving subsidies for coverage. Individual enrollment both on and off the marketplace is also at a record high, meaning this enrollment period could be the busiest yet because of the number of people renewing coverage.
ACA subsidies have been extended
Premium tax credits for Affordable Care Act (ACA) plans were increased by the 2021 American Rescue Plan Act and were set to expire at the end of 2022.
The now-passed Inflation Reduction Act extends the subsidies through 2025 to people with incomes over 400 percent of the federal poverty level, which is $54,360 for a single person and $111,000 for a family of four. Premium payments are now capped at 8.5 percent of household income.
More plan choices than ever
Most major payers have greatly expanded their Affordable Care Act (ACA) offerings this year to new states and counties, and the Biden administration is touting 2023 as the most “competitive marketplace in history” for exchange plans.
According to CMS, a total of 220 insurers will offer plans on the marketplace this year, an increase of 7 percent from 2022. In addition, 92 percent of Americans will have three or more options to choose from on their marketplace, which is up from 89 percent last year.
Four in 5 customers will be able to purchase a plan for $10 or less due to the IRA subsidies.
The “family glitch” has been fixed
Before Nov. 1, the federal definition of affordable employer-provided coverage was only for single individuals and not for family members, meaning about 5.1 million people were ineligible for marketplace subsidies.
To fix the glitch, President Joe Biden directed the Treasury Department and Internal Revenue Service to allow family members of employees who are offered affordable self-only coverage but unaffordable family coverage to qualify for the subsidies to purchase family health coverage through their marketplace.
Around 1 million people will either gain coverage or have more affordable coverage as a result of the new rule, according to HHS.
The federal government is investing millions to enroll underserved individuals
In 2022, CMS is investing $98.9 million in organizations that help people navigate the Affordable Care Act (ACA) marketplace, Medicaid and Children’s Health Insurance Program enrollment for the 2023 enrollment period.
Grants given to 59 “navigator” organizations will help retain and add staff who are trained to help people find health coverage. More than 1,500 navigators helped with enrollment in nearly every HealthCare.gov state and county during last year’s enrollment period.
CMS said navigator organizations will focus outreach efforts on people who identify as racial and ethnic minorities, people in rural communities, the LGBTQ community, American Indians and Alaska Natives, refugee and immigrant communities, low-income families, pregnant women and new mothers, people with transportation or language barriers or lacking internet access, veterans and small-business owners.
Eligibility rules have been relaxed
According to KFF, a rule previously allowing payers to deny renewed coverage for individuals with a standing premium balance has been abolished.
In addition, there will be a 60-day special enrollment period in mid-2023 for people to sign up for Affordable Care Act (ACA) coverage if they have a qualifying life event such as loss of other coverage or change of marital status.
Source: Becker Spayer
