The Affordable Care Act (ACA), also known as Obamacare, is a federal law passed in the United States in 2010.
All health insurance plans that comply with the Affordable Care Act are required to offer coverage for specific essential health benefits, including emergency services, family planning, maternity care, hospitalization, prescription drugs, mental health care, and pediatric services.
The 2023 Affordable Care Act (ACA) Open Enrollment period run from November 1, 2022, and ended last January 15, 2023, in most states. Even after a decade of operation, changes continue to occur in these markets.
Some of the changes to watch for include:
Increased unsubsidized premiums
ACA Marketplace benchmark premiums are expected to increase by an average of 4% across all 50 states and DC, with state-average benchmark premium changes ranging from a decrease of 18% in Virginia to an increase of 15% in New Mexico. The majority of Marketplace enrollees receive a subsidy and are therefore largely shielded from these increases, but they may need to switch plans to take full advantage of the subsidies.
Enhanced Marketplace subsidies
Expanded and enhanced marketplace premium subsidies, enacted under the American Rescue Plan Act (ARPA) and the Inflation Reduction Act (IRA), will continue to reduce net premiums for most consumers. The subsidies now fully cover the cost of enrolling in the benchmark silver plan for consumers with income up to 150% of the federal poverty level and extend eligibility for premium tax credits to reach people with incomes over 400% of the federal poverty level.
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High Marketplace Enrollment
According to a news release, Marketplace enrollment reached a record high of 13.8 million people in 2022 and is likely to be even higher this year. The 2023 open enrollment period is expected to be hectic, with an increased number of individuals renewing their existing coverage and also seeking new coverage options.
Plans available to new enrollees
There will be a range of new health insurance plans available to new enrollees, including some with lower premiums and cost-sharing subsidies. The plans will vary by state, so consumers should compare their options to find the best plan for their needs.
New outreach and enrollment assistance
There will be increased outreach and enrollment assistance, with more options for in-person, phone, and online assistance available. Consumers should take advantage of these resources to ensure they are enrolling in the best plan for their needs.
The eligibility rules for HealthCare.gov have been relaxed
The rules regarding eligibility for HealthCare.gov have been made more lenient. In the past, insurance companies offering policies on the site were allowed to refuse to renew coverage for individuals who failed to pay their premiums. However, this will no longer be the case starting in 2023. People who missed premium payments in 2022 or let their coverage lapse due to nonpayment can still enroll in a 2023 policy offered by the same insurer, and the binder payment (January 2023 monthly premium) cannot be used to pay for past-due premiums.
Subsidies for high-cost plans
The Inflation Reduction Act also provides subsidies for high-cost health insurance plans, which will help to reduce the cost of coverage for consumers with high health care expenses.
Essential Health Benefits
All health insurance plans offered through the Marketplace must cover Essential Health Benefits, which include services such as hospitalization, mental health, and prescription drugs.
Year-round enrollment for low-income individuals
Those with annual income up to 150% of FPL ($20,385 for a single person, $34,545 for a family of 3 in 2023) can enroll in marketplace plans at any time. The low-income SEP, established in 2022, will continue to be offered. It’s recommended to sign up during Open Enrollment for full-year coverage because the coverage automatically begins the first day of the month after enrollment.
Overall, the 2023 Affordable Care Act Open Enrollment period presents a range of new opportunities for consumers to enroll in health insurance coverage. Consumers should take advantage of the enhanced Marketplace subsidies, new plans, and expanded outreach and enrollment assistance to ensure they find the best coverage for their needs.
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