The health insurance Open Enrollment Period (OEP) is coming, and you might feel a little lost. It can be hard to sort through all of the different health insurance options in your area, but you know that you and your family need health insurance to stay healthy. Don’t worry though. You can always work with a licensed EZ agent, who will help you find a plan that fits your budget and your needs. Before you do that, let’s look at everything you need to know about the OEP.
What Is The OEP?
The Open Enrollment Period (OEP) is the only time of the year when you can change, cancel, or buy a new health insurance plan. Depending on which state you live in, it starts on November 1st and goes until mid-to late-January. Now is a good time to look at your current health insurance plan, see if it will change in the new year, and decide if it will meet your needs in the future or if you need a new plan.
When Is The OEP?
The open enrollment period for Obamacare plans is from November 1, 2023 to January 15, 2024. Any plan you buy by December 15 will cover you starting on January 1, 2024. If you buy a plan during open enrollment, which is between Dec. 15 and Jan. 1, it should take effect by Jan. 15, 2024, as long as you pay your first premium on time. Also, if you buy a plan between Jan. 1 and Jan. 15, your plan should start on Feb. 1, 2024. Some states’ open enrollment periods are longer than others, but this can change. At the moment, these states have longer periods for signing up:
California – November 1st, 2023, to January 31st, 2024
Idaho – October 15th, 2023, to December 15th, 2023
Maryland – November 1st, 2023, to December 15th, 2023
Massachusetts – November 1st, 2023, to January 23rd, 2024
New Jersey – November 1st, 2023, to January 31st, 2024
New York – November 16th, 2023, to January 31st, 2024
Rhode Island – November 1st, 2023, to December 31st, 2023
If you get your health insurance through your job, your employer can choose when your open enrollment period is.
Marketplace Plan Tiers
Since the Affordable Care Act (ACA) went into effect in 2010, most people buy traditional health insurance plans on the insurance marketplace during the OEP. When you buy plans this way, they come in four levels called “metal tiers.” Bronze, Silver, Gold, and Platinum are the tiers. The plans in these tiers are different in terms of price and how much you’ll have to pay out of pocket, not in terms of the quality of care you’ll get.
Bronze
The monthly premiums for bronze plans are the cheapest, but you have to pay the most out of pocket. With these plans, your insurance company will pay 60% of each of your medical bills. The other 40% will be your responsibility. Also, the deductibles for these plans, which are the amount you have to pay out of pocket for medical costs before your insurance plan starts to pay for them, can be in the thousands of dollars each year. Bronze plans are a good choice if you don’t use medical services very often but need a low-cost plan to protect yourself against the worst-case medical scenarios, like getting sick or hurt badly. Your monthly premium will be low, but since the deductible and cost-sharing percentage are both so high, you will have to pay for most of your routine care.
Silver
The monthly premiums and out-of-pocket costs for silver-tier plans aren’t too high or too low. These plans cover 70% of the cost of your medical care. You pay the other 30%. The deductibles for this tier are often lower than those for Bronze plans, so if you’re willing to spend a little more to have more of your routine care covered, these plans are a great choice. When you qualify for cost-sharing discounts, you have to choose a Silver plan to get the extra savings. If you are on the Silver plan and stop getting cost-sharing reductions, you will have a Special Enrollment Period. If you want to switch plans, you can sign up for the Bronze, Silver, or Gold plan that fits your needs and budget the best.
Gold
Even though the premiums for Gold plans are high, the out-of-pocket costs of care are lower than for the plans above it. These plans have low deductibles, and your plan will pay for 80% of your care while you only pay 20%. If you need a lot of medical care, a Gold plan might be a good choice for you because it will cover more of your care.
Platinum
Platinum has the highest monthly premiums of all the tiers. While the premiums will be high, your out-of-pocket costs will be the lowest of any type of plan, and since the deductibles are so low, your insurance company will pay more of your costs throughout the year. Since these plans cover 90% of all your medical costs, they can be a good deal for people who need a lot of medical services.
In addition to the different types of metal tiers, there are also different types of plans to choose from during the OEP. Some plans only let you choose from a small number of doctors, hospitals, pharmacies, and other health care providers, or they force you to use only those in their network. On the other hand, some plans will pay a bigger share of the bill for healthcare providers outside of the plan’s network. Depending on where you live, you might find plans in any or all of these categories at each metal tier level:
Health Maintenance Organization (HMO) – A type of health insurance plan that usually only pays for medical services from doctors who work for the plan or have contracts with it. Most of the time, out-of-network care is not covered, unless it is an emergency.
Preferred Provider Organization (PPO) – A type of health plan that has a network of providers but doesn’t force you to only see those providers. But your out-of-pocket costs will be lower if you use providers in the network. You can use medical professionals, facilities, and suppliers outside the network if you pay extra and don’t have a referral.
Exclusive Provider Organization (EPO) – A managed care plan is one in which treatments are only covered if you go to doctors, hospitals, or other healthcare providers in the network, unless it’s an emergency.
Point of Service (POS) – A type of plan where you pay less if you go to hospitals, doctors, and other healthcare providers in the plan’s network. To see a specialist, you need to get a referral from your primary care doctor.
How To Buy Health Insurance During The OEP
If your employer gives you health insurance, they should tell you when and how to choose coverage for the next year. If you don’t get health insurance through your job, you can use the marketplace to look for and buy a plan. Another way to buy health insurance during this time is to work with an EZ agent who can help you shop through all of the plans available and help you enroll. Most states use the federal marketplace, healthcare.gov, but 17 states and Washington, D.C., have their own state-based marketplaces where people can buy coverage. States that run their own health insurance exchanges may also offer longer sign-up periods. These are the states that have their own insurance markets where people can buy plans for 2024:
Residents of all other states should shop for and sign up for their next health insurance plan on the federal exchange.
Things To Consider During The OEP
As Open Enrollment for Individual and Family Health Insurance in 2024 gets closer, there are a few important steps to take when choosing your plan.
Review Your Current Plan
If you already have health insurance, look it over to see if it still meets your needs. Think about any changes in your health, finances, or lifestyle recently that might mean you need a different health insurance.
Explore Options
During Open Enrollment, it’s important to look at different plan options to find one that fits your healthcare needs and budget. Look for plans that have a network of doctors and hospitals that fit your needs and preferences.
Consider Subsidies
As you look at and compare insurance plans on the Marketplace, make sure to update your personal information, especially your financial information. If you make less than a certain amount of money, you may be able to get health insurance subsidies that can lower your monthly premium by a lot. Also, Silver Marketplace plans offer cost-sharing reductions, which can lower your out-of-pocket costs by lowering your deductible, copays, and coinsurance.
Consider Additional Coverages
Even though Marketplace health insurance plans cover a wide range of medical services and include prescription drug coverage, you may want to think about getting more coverage, like dental and vision plans, to make sure your health is well-rounded.
What If I Miss The OEP?
If you miss the Marketplace’s Open Enrollment Period, you might not be able to sign up for an ACA health insurance plan unless you qualify for a Special Enrollment Period. With a Special Enrollment Period, you can sign up for a plan outside of the Open Enrollment if you have a qualifying life event. This is an event that affects your current coverage, like losing your job or getting divorced. You might also be able to sign up for a health plan through your employer. Some plans offered by employers have their own enrollment periods that may differ from the Marketplace. Also, if you change jobs, you may be able to sign up for your new job’s health plan outside of the normal enrollment period.
Need Help?
The best way to find a cheap plan with the right level of coverage for you is to compare plans. Come to EZ first before you start comparing things on your own. We’ll make the process faster and easier by letting you compare plans in your area in just a few minutes. Our licensed insurance agents work with all of the best insurance companies in the country. They can talk to you about your budget, needs, and help you choose the best plan for you and your family. We compare plans and give you advice for free. Enter your zip code in the bar above to get free quotes or call 877-670-3557 to talk to a real person.
If you’ve missed the health insurance Open Enrollment Period (OEP), or if you have had a sudden lapse in your insurance coverage, you might be stressing over how to get covered. But don’t worry, you still have options! One of your best options will be a short-term health insurance plan. These plans tend to be less expensive than traditional health insurance because they provide very limited coverage, and so they are usually meant as a stopgap for generally healthy people. So, what do these plans cover (and what don’t they cover), and what are the specific rules surrounding them?
Compared to traditional health insurance plans, which typically include a comprehensive range of benefits, short-term health insurance plans offer significantly less coverage. In fact, they are not required to provide coverage for the “10 essential health benefits” that traditional ACA-approved plans are required to cover.
That means short term health plans are not required to provide coverage for:
Pre-existing conditions
Medications
Maternity care
Mental health
Substance abuse treatment
But, with that being said, short term health plans are better than nothing, and generally provide coverage for:
What you can expect to pay for a short-term health plan will be determined by the specific plan that you choose, as it would be with any other type of insurance. You will be responsible for paying a monthly premium, in addition to:
Deductibles – As with other types of insurance, with a short-term plan, you pay for services out-of-pocket until your deductible is met. After that, your plan will start to split costs. Short-term health plans can have deductibles that are much higher than those of other, more traditional health plans.
Coinsurance – After you’ve met your deductible, your plan will cover your medical expenses in part, but you will also have to pay a percentage, known as coinsurance. For example, you might have to pay 30% of each covered medical expense, while your plan covers 70%.
Copays – This is a set fee that you may have to pay when you use a medical service. For example, you might have to pay $20 at the point of service when you go to the doctor.
Other expenses – If there are health care services that your short-term plan doesn’t cover, you might have to pay for them completely out-of-pocket. For instance, some short-term plans might not cover or only cover a certain amount of maternity care, mental health or substance use services, vision care, or dental care. If you need these services, you’d have to pay for them yourself.
One good thing about the costs of these plans is that their monthly premiums are typically much more affordable than the premiums for plans offered under the Affordable Care Act (ACA). With that being said, the reason that they are sold at a lower price is because most of the time, these plans don’t cover much, and only a portion of the monthly premium actually winds up being applied toward the cost of actual medical care.
Short Term Plans State-by-State
When it comes to the rules surrounding short term plans, every state is different. In fact, some states don’t even allow residents to buy these plans, but most allow a limited length of time to have one of these plans.
The following states allow you to have coverage with a short-term plan for 364 days, and allow you to renew up to 3 times for a total of 3 years of short-term coverage:
For more in-depth information on your state’s laws surrounding short term insurance, check out our state-by-state guides to health insurance.
Pros and Cons of Short-Term Plans
Short term plans can give you a number of advantages. But you should be aware that there are some drawbacks to this option as well. Knowing both the pros and cons of these plans will help you make an educated decision.
Pros
Affordability – The low price of these plans’ premiums is a highly attractive benefit.
Quick coverage – Plans usually go into effect within 7-14 days of enrolling.
Easy Cancellation – It is possible to terminate short-term insurance plans with little advance notice, particularly if you pay for your plan on a month-to-month basis.
Cons
Renewal Limitations – Short term plans do not automatically renew, and the number of times you are allowed to renew them is usually capped.
Coverage Limitations – In most cases, a temporary health insurance plan will not include coverage for all ten essential health benefits.
Availability Limitations – Not all states or insurance companies offer short-term plans to their customers.
Qualifying for Short Term Health Insurance
As discussed above, the majority of states permit short-term health plans, but there are a few that do not, and others that place restrictions on how long coverage can be maintained.
But even if your state permits short-term plans, you may still be denied coverage by an insurance company for health reasons. For example, you might be denied a short-term plan if you have a serious preexisting medical condition, or if you’re currently expecting a child.
In general, you will qualify for short term plans if you:
Are young and healthy.
Missed the OEP, and don’t qualify for a Special Enrollment Period
Are out of work and can’t afford COBRA or an ACA plan and need coverage in the meantime.
Are almost eligible for Medicare but do not want to enroll in a full year-long plan.
If you have a pre-existing condition, such as asthma or diabetes, you might want to steer clear of short-term plans even if you can get approved, because your premiums will be significantly more expensive, since these plans are not subject to ACA rules on preexisting conditions.
How to Buy Short Term Plans
Although you may be able to enroll in a short-term plan in person in some circumstances, the most common method for purchasing short-term health insurance is doing so online. You can also contact an insurance company that specializes in selling short-term plans directly.
Because of the state regulations surrounding short term health plans, and because these plans are offered by both national and regional companies, their availability is highly dependent on the state you live in. National companies sell short term health plans in multiple states, and regional companies have more localized service areas, so you’ll need to shop around. Speak to an EZ agent about what companies in your area offer the best short-term health plans.
FAQs
Will my doctor accept short term health insurance?
It depends on the plan. Some plans require you to stay in their network of doctors, with other plans, you can choose your own doctor and hospital without being subject to any restrictions. With that being said, in this case, there may still be financial incentives for using in-network providers.
Are pre-existing conditions covered?
When you apply for a short-term health plan, you’ll have to answer a short list of questions about your health, including about preexisting conditions. There’s a chance you will be denied coverage if you have certain preexisting conditions, and even if you are considered eligible for coverage, your plan will most likely not provide coverage for treatment of your preexisting condition.
So, when applying for one of these plans, examine the policy’s wording thoroughly. It’s common practice for short-term plans to use post-claims underwriting, which means that they’ll take your word for it about your health when you sign up, but can check your records after you’ve filed a claim to make sure you weren’t lying about any preexisting conditions.
Is losing my short-term coverage considered a qualifying life event?
Since short term health plans are not ACA-approved plans that provide minimum essential coverage, losing such a policy does not warrant a Special Enrollment Period that will allow you to shop for an ACA-compliant plan outside of Open Enrollment.
So, is a Short Term Plan the Best Option?
The purpose of short-term health plans is to provide healthy people with temporary, limited protection. Therefore, those who have ongoing medical needs or who have a history of illness should avoid short term health plans. If you’ve lost your coverage, and are in-between plans and looking to cut costs, short term health coverage is the way to go. But before you make a purchase, you should think carefully about whether or not it will meet your needs.
You can get information on short term health plans by contacting EZ.Insure and speaking with a licensed agent. We’ll go over all the details with you and help you figure out if one of these plans is right for you. And if it turns out a short-term health plan isn’t the best option for you, we’ll find you something that fits your budget and your health status. Get an instant quote by entering your zip code in the box below, or to speak to an agent directly, call 877-670-3557.
If you remember the passage of the Affordable Care Act (or ACA, also commonly known as Obamacare), you probably remember that it was a bit controversial at the time. One of the reasons it was controversial was that it included a health insurance mandate. Meaning that is was mandatory to ++enroll in an insurance plan through the ACA Marketplace (or have a state-funded plan), or pay a tax penalty at the end of the year.
But since the law’s passage in 2010, it has undergone a few changes. Leaving a lot of people confused about its requirements. So if you’re wondering whether health insurance is mandatory, the answer is: it depends. And even if you aren’t required by law to have health insurance, you definitely should. Not having a plan might save you a little money now, but you could be hit with large medical bills in the future if you don’t have coverage. And not only that, but the ACA didn’t just mandate coverage, it also made sure that plans cover all sorts of preventive care. So, you can stay healthier with an ACA-approved plan.
Below, we’ll go over what’s mandatory when it comes to health insurance, based on where you live. As well as give you some tips on how to get the best plan for you.
The objective of the Patient Protection and Affordable Care Act (ACA), which was passed into law in 2010, was to increase access to health insurance for all Americans. This was true even for people with preexisting conditions, who before the ACA was passed often had trouble getting coverage.
One of the ways that the Affordable Care Act effectively made having health insurance mandatory was by imposing a tax penalty for those who did not have coverage. And why did it create this mandate and tax penalty? The same reason it created the Open Enrollment Period. Which is the only time you can buy health insurance (unless you have a Special Enrollment Period granted to you). So that people would buy health insurance before they got sick, and the risk pool would be spread among everyone, not just those who needed their insurance right at that moment.
So now that we’ve looked briefly at why there was a mandate when the law was passed. What about right now? If you don’t have health insurance, what are the consequences?
As of now, there are none, at least on the federal level. As of January 1, 2019, the federal government no longer requires its citizens to carry health insurance. The ACA is still in effect, but that part of the law has been done away with. But that doesn’t necessarily mean you’re off the hook: health insurance requirements now depend on the state you live in.
State Health Insurance Mandates
Despite the fact that having health insurance is not mandatory on a federal lever anymore, a number of states either already have coverage mandates on the books or are attempting to pass laws that would make having health insurance mandatory. In the states that have mandates, you will have to pay some sort of penalty if you do not have adequate coverage.
The states that health insurance is mandatory are:
California
Massachusetts
New Jersey
Rhode Island
Vermont
Additionally, the states of Connecticut, Hawaii, Maryland, and Minnesota, along with the state of Washington, have all attempted to pass legislation that would health insurance mandatory for residents.
In the states where having health insurance is mandatory, coverage can be obtained through the Health Insurance Marketplaces that are run by the state. The guidelines for obtaining and retaining coverage are comparable to those outlined in the Affordable Care Act (ACA). Below we’ve highlighted the state mandates, but for more information make sure to check out our state-by-state health insurance guides.
In California, people who don’t have health insurance will have to pay a fine of 2.5% of their household income or at least $750 per adult and $375 per dependent under 18 every year, adjusted for inflation each year. The penalty can’t be more than the average state premium for a Bronze plan on the California exchange for the size of the household, and the penalty doesn’t apply if the premium is more than 8.3% of the household income.
There are a few exemptions, which would keep you from having to pay the penalty, such as:
Religious exemptions – You or a member of your family may be eligible for a religious conscience exemption if you adhere to a religion that forbids private health insurance as a concept, or has a firm belief that physical illness can be cured solely through spiritual means.
Hardship exemptions – If you are unable to obtain health coverage because you are facing financial challenges, such as being homeless, have an eviction notice, experiencing a natural disaster, experiencing domestic violence, filing for bankruptcy, etc. You might get an exemption from the penalty.
Affordability exemption – If the monthly premium for the least expensive plan that is available to you would cost more than 8.27% of your household income, you are exempt from the tax penalty.
Small coverage gap exemptions – If you only went without coverage for less than 3 months. you will not have a penalty.
Indigenous people exemptions – If you are part of a federally recognized Native American Nation, health insurance is not mandatory.
The state of Massachusetts has one of the highest levels of insurance coverage in the United States. 97.5% of this state’s residents have health insurance, since the state mandates that all residents have insurance. The individual mandate in Massachusetts was in place well before the individual mandate in the Affordable Care Act, and its healthcare laws served as a guide for the individual mandate in the ACA.
In Massachusetts, the amount of the penalty varies depending on your income, age, and the size of your family. It can, though, be as much as 50% of the minimum monthly premium payment that you would have qualified for through Health Connector. The health insurance exchange in Massachusetts. But the tax penalty cannot be more than the cost of the least expensive plan for which you are eligible.
If you live in Massachusetts and are unable to afford one of the state’s health insurance plans. You will not pay fines for going without coverage. In most cases, this means your household income is at or below 150% of the federal poverty level.
In New Jersey, the penalty you have to pay if you do not maintain a health insurance policy is known as the Shared Responsibility Payment. This penalty is calculated according to both household income (including that of any dependents) and family size. The fine, though, cannot exceed the state median premium for Bronze health plans.
There are exceptions to the mandate under New Jersey law. You may be exempt from purchasing health insurance if, for instance, you are unable to afford the plans offered by the Marketplace or your employer. The cost of the plan premiums can’t be more than 8.05% of your annual household income. In addition, those who cannot comply due to a religious belief may be exempt from having to pay the penalty.
In Rhode Island, if you do not have health insurance that complies with the ACA, you will be subject to the same penalty that existed under the federal individual mandate. The fines go up each year to keep pace with inflation. But the maximum penalty per household cannot exceed the annual cost of a typical Rhode Island Bronze plan.
When filing state taxes in Vermont, residents are obligated to disclose whether or not they are covered by health insurance. You will not be fined for not having medical insurance here, though. Unlike in other states that have passed individual mandate laws.
Although there is currently no financial penalty for Vermont residents who do not comply with the state’s individual health insurance mandate. This is not to say that there will never be such a penalty. If you live in Vermont and have to have health insurance that complies with the Affordable Care Act but don’t, you should know that lawmakers are considering imposing a penalty.
FAQs
What if I have a gap in my insurance?
If you had insurance, but let it lapse for less than three consecutive months, that is a short gap in coverage. You probably won’t have to pay a penalty in this case. Even in places like Vermont, California, New Jersey, Rhode Island, Massachusetts, or Washington, DC. To avoid tax penalties, though, you should not let your policy lapse more than once a year. And be sure to accurately report it on your state tax return. You will need to reapply for exemption in subsequent years if this continues to be an issue.
Why would anyone go without health insurance?
There are a variety of reasons why someone would go without health insurance. Some people might think they can’t afford it, while others may have questions about the health insurance enrollment process. It’s also possible that former employees have no idea they no longer have access to their former employer’s group health plan. Make sure you and your family have protection against the risks of not having health insurance. If you have any problems or questions, EZ.Insure is here to assist you.
What is so risky about not having health insurance?
Without health insurance, you expose yourself to a number of serious dangers. If you need medical attention but don’t have health insurance, for instance, you’ll have to pay for it entirely out-of-pocket. This could be prohibitively expensive; in fact, medical bills are a leading cause of personal bankruptcy. Of course, you might also be subject to a local income tax penalty. And you will also be less likely to get preventive care that can keep you healthy. In light of all this, you and your loved ones need adequate insurance coverage.
Let EZ Help
You can find a plan that fits your budget and provides adequate coverage by comparing different options. But we get that this can feel a bit overwhelming. So come to EZ before you go to the trouble of comparing on your own. We will save you time and effort by quickly comparing the various options in your area. If you’re looking for affordable coverage that still meets your family’s needs, our licensed agents can help you compare plans from the nation’s best-known insurers. We provide unbiased plan comparisons and advice at no extra cost. Free quotes are available by entering your zip code in the box below. Or by calling 877-670-3557 to speak directly with an agent.
The past couple of years have been unpredictable to say the least, bringing hundreds of thousands of hospitalizations and deaths due to Covid-19, as well as job losses and financial struggles to many. Because of all of this, it is more important now than ever to make sure you and your family are insured. Now is the time to do that: the ACA Open Enrollment Period is here, giving you the opportunity to find a great plan or make changes to the plan you already have. Don’t put it off, especially since this year there are so many reasons you need to pay attention to the Open Enrollment Period.
1. More Options
More health insurance options are added in your area every year.
One of the most important reasons to look around during the Open Enrollment Period is that you simply might not be aware of all the options for plans and savings that are available to you. In fact, KFF polling finds that public awareness about ACA coverage options has fallen somewhat since the law passed a decade ago: for example, 59% of the public knows the ACA offers subsidies for marketplace health plans, compared to 75% ten years ago.
The ACA is constantly changing and growing, providing more Americans with health insurance than ever before, both because of expanded access to subsidies and because some health insurance companies have been expanding into new areas and offering new health insurance plans around the country. That means you have more options than before, so there could be a better, more affordable health insurance plan out there that will provide you with more coverage.
2. Greater Need For Insurance
The pandemic has proven just how necessary health insurance really is. Sure, Covid-19 testing and vaccines are free, but what if you or your loved one needs to be hospitalized? Without insurance, you would not be covered for the hospital bill you or your family would receive when being treated for Covid or any other illness, which could leave you with tens of thousands of dollars in debt. That could be avoided by having the right health insurance.
And what if you lost your job like millions of other Americans? If you did, you probably lost your health benefits along with your job; but just because you’ve lost your job, doesn’t mean you can’t still find affordable health insurance with the help of an EZ agent. With all of the subsidies now available, you could possibly even pay $0 in premiums, which we will discuss later.
Almost all health insurance plans will have changes in their plans, including price increase for the following year.
Less than half of all Americans (43%) know that Open Enrollment is the only time to sign up for Marketplace plans, meaning not only do many people miss out on signing up for health insurance, but many others don’t use the time to review their plans and make sure they’re still right for them. This is a big mistake, because your plan might actually have changes coming to it for the new year. For example, rates will most likely go up next year, and some plans will drop doctors and other providers from their network, while others will add more. Be aware of the changes to your plan and any other plans in your area, otherwise you might miss out on the right one for you!
Now onto the savings you can expect to see this Open Enrollment Period! Thanks to President Biden and his American Rescue Plan Act (ARPA), you could qualify for a subsidized health insurance plan if your modified adjusted gross income is over 400% of the federal poverty level. For 2021, that’s about $51,040 for an individual. The ARPA also requires that Americans pay no more than 8.5% of their income on health insurance premiums, and provides a larger tax credit to people who already receive financial assistance.
What does that mean for the average American? For most, ACA premiums will decrease by about $50 per month, while one administration official emphasized that 4 out of 5 people enrolling “will be able to purchase a plan for $10 or less per month.” This could make a huge difference in the lives of the 14.9 million people who are currently not insured in the U.S.
Comparing plans is the best way to find an affordable plan that provides the right level of coverage for you. Before you start doing the work of comparing on your own, come to EZ. We will make the process quicker and easier by comparing available plans in your area in minutes. Our licensed agents work with all the top-rated insurance companies in the nation and can go over your budget and needs, and find the best plan for you and your family – and we do all of this at no cost to you. To get free quotes, simply enter your zip code in the bar above, or to speak directly with an agent, call 888-350-1890.
The ACA Open Enrollment Period is the only time of the year when everyone can enroll in a health insurance plan. But can literally anyone enroll, or is there any reason you can be denied coverage during this time? The short answer to this question is no: the whole idea behind the creation of the Affordable Care Act (ACA) was to make sure everyone could get insurance. But being allowed to get insurance is different from insurance being accessible to all – so how does the ACA remove all the barriers to getting insurance and make everyone truly able to get the plan they need?
What The ACA Has Done for Millions
Before the ACA was passed in 2010, you could have been denied a health insurance plan simply because you had a pre-existing condition. That meant a huge amount of Americans were unable to find affordable health insurance: approximately 43% of U.S. households report having pre-existing conditions. And indeed, health insurance was out of reach for many before 2010: when the ACA went into effect approximately 46.5 million people, or 17.8% of the total nonelderly population, were uninsured.
But the ACA, with its Patients’ Bill of Rights that prohibits insurers from discriminating based on pre-existing conditions or revoking your coverage because of an unintentional mistake on an application, changed everything. 31 million people have enrolled in health insurance plans through the Affordable Care Act since it was enacted, and that is a huge accomplishment! But there has been criticism over the years that health insurance, while available to everyone, was still not accessible to everyone – but that has all changed.
The American Rescue Plan Act has offered more people the ability to save more money on their health insurance premiums.
save afcad
Earlier this year, President Biden passed the American Rescue Plan (ARP), which has made health insurance far more affordable for far more people. It extended premium tax credits to more Americans by allowing people who earn over 400% of the federal poverty level to receive subsidies to purchase health insurance through the ACA Marketplace; it also requires that Americans pay no more than 8.5% of their income on health insurance premiums, and provides a larger tax credit to people who already receive financial assistance.
What all of this means is cheaper premiums! For most people, premiums will be at least $50 per month cheaper, while some people might pay $0 in premiums. With the new law:
An individual making $19,000 or less per year will not have to pay a monthly premium for health insurance.
Couples who earn less than $70,000 together will save $1,000 per month on their health insurance monthly premiums.
A family of 4 with an income of $90,000 will pay about $200 less in health insurance premiums.
The bottom line is you can never be denied health insurance coverage during the Open Enrollment Period; not only that, but insurance is now affordable for everyone, so there is no reason you can’t get a plan that is right for you. It is important to note, though, that the Open Enrollment Period is the only time you will be able to get coverage: if you miss the OEP, you will have to wait until next year’s OEP, unless you qualify for a Special Enrollment Period. Don’t let this period pass you by – it’s the perfect (and only) time to get a great affordable health insurance plan!
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President Joe Biden has nominated Chiquita Brooks-LaSure to be Administrator of the Centers for Medicare and Medicaid Services (CMS). Ms. Brooks-LaSure took part in setting up the ACA’s commercial health insurance programs as well as its public health insurance exchange system under former President Obama. If her nomination is confirmed by the Senate, she will be the first African American woman to be CMS Administrator.
As head of the CMS, Brooks-LaSure would help regulate almost $3 trillion in spending by Medicare plans, Medicaid plans, and individual and group major medical policies that fall under the ACA. Many are hopeful that, because of her background, she will move the health insurance industry in the right direction.
Ms. Brooks-LaSure got her Bachelor’s degree from Yale University.
Brooks-LaSure’s Background
Brooks-LaSure earned a master’s in public policy from Georgetown University and, before that, a bachelor’s degree from Yale University. She has an impressive track record in the government: she held health policy jobs at the White House and at CMS during the Obama administration. From 1999-2003, she worked as a program examiner in the Health and Human Services Branch at the White House Office of Management and Budget. She then went to work as director at Avalere Health from 2003-2007.
After those 4 years, she decided to go back to work for the federal government. She spent from 2007-2009 on the staff of the House Ways and Means Committee, then from 2009-2012, she was director of coverage policy at the HHS Office of Health Reform. Lastly, from 2012-2014, she was deputy director of policy and regulation at the Center for Consumer Information and Insurance Oversight.
Health Groups Praise Biden’s Pick
Healthcare providers are happy with President Biden’s choice because of Ms. Brooks-LaSure’s background.
Providers are happy with President Biden’s pick of Ms. Brooks-LaSure. “America’s hospitals and health systems applaud the nomination of Chiquita Brooks-LaSure to serve as the next administrator of CMS,” American Hospital Association President and CEO Rick Pollack said in a statement. “She is well equipped to lead CMS and we look forward to working with her to defeat the COVID-19 pandemic and advance the health of all our patients and communities.”
America’s Essential Hospitals (AEH) released a statement supporting Brooks-LaSure’s nomination, citing her “deep expertise in Medicaid and Medicare policies and her role in advancing coverage” under the ACA.
“We also welcome Brooks-LaSure’s nomination due to her long-standing focus on disparities in health and health care, such as those that affect the underrepresented people our hospitals serve,” Bruce Siegel, MD, MPH, CEO of AEH, said in a statement. “Her work to combat maternal mortality and morbidity makes her well suited to meet this urgent challenge for our nation.”
As of now, no confirmation hearing has been scheduled.
