The 2020 Open Enrollment Period may have ended most states, but it continues for residents of California, New York and the District of Columbia. Combined, they represent over 60 million people, or 18% of the entire U.S. population:
If you still missed the deadline, you won't be eligible to enroll for ACA-compliant major medical coverage for the rest of the year unless you qualify for a Special Enrollment Period (SEP) due to a qualify life event like getting married/divorced, moving, giving birth/adopting a child, turning 26, becoming ineligible for Medicaid or losing your employer-sponsored health insurance coverage.
Note: There's a ton of junk plans and scam artists out there, especially these days. Fraudulent plans are being hawked endlessly via both robocalls, spam emails and fly-by-night websites. If you're enrolling online, make sure to use one of the official ACA exchange websites listed above.
You can also enroll in ACA-compliant policies directly via the insurance carrier's website as well, but the only way to be eligible for ACA tax credits is if you enroll on-exchange.
SPECIAL NOTE FOR CALIFORNIA RESIDENTS:
As I noted above, not only have California and the District of Columbia reinstated the individual mandate penalty (which could be more than $2,000 for a family of four), but California has also expanded ACA premium tax credits to hundreds of thousands of middle-class residents who didn’t previously qualify for them.
The official ACA tax credits cap your premiums for a Silver plan at no more than between 2.0 — 9.8% of your household income on a sliding scale...but only if you earn less than 400% of the Federal Poverty Line (FPL), which is around $50,000 if you’re single or $103,000 for a family of four.
This means that in every other state, if you earn even $1 more than the cut-off amount, you receive no help and have to pay full price. In California starting in 2020, however, the maximum income cap has been raised to 600% FPL, or around $75,000 if you’re single or $154,000 for a family of four. They also made the formula below the 400% level a bit more generous as well.
How much of a difference could this make for you?
Well, if you’re a young individual, it won’t save you tons, but it can still cut your premiums down by several hundred dollars per year.
What about a family? Well, a family of four (40-year old couple with two young kids) living in Sacramento will save up to $8,400/year.
What about older adults? If you’re a 64-year old single adult just a year out from Medicare, you could save as much as $8,700/year.
Finally, what about a 60-year old married couple? If they earn around $68,000/year (just over the 400% threshold) they’ll save nearly $18,000/year.
THAT IS NOT A TYPO.
California’s expanded subsidies aren’t ideal, of course; they still allow premiums to ramp up to as much as 18% of income at the 600% FPL threshold, and the “subsidy cliff” reappears again over that level...but they sure as hell help mitigate the problem for a lot of people within the 400-600% range, and offer a nice little bonus to those below 400%.
#GetCovered TODAY. You only have until FRIDAY NIGHT to do so if you haven’t already.
NOTE: Since June 2019, I’ve been contracted to do occasional healthcare data analysis & advocacy for the Center for American Progress.