The special open enrollment period for health insurance was extended until August 15; new rules expand who qualifies


President Joe Biden made the announcement to extend the special enrollment period on March 23, the 11th anniversary of the Patient Protection and Affordable Care Act becoming law. It was originally set to end May 15. (Click for larger graphic)

The special enrollment period includes enhanced premium subsidies, also known as tax credits, to help offset the cost of the marketplace’s health insurance plans. It also makes more people eligible for the subsidies and eliminates repayments that may be required when people reconcile their tax return with the tax credit they received. Under the ACA, only people with incomes between 100% and 400% of the federal poverty level were eligible for a tax credit to reduce their premiums for marketplace coverage.

Under the relief bill, subsidized premiums will drop an average of $50 per person per month, according to a federal fact sheet. It also says four out of five enrollees will be able to find a plan for $10 or less per month after the tax credit, and most will be able to find a “silver” plan for $10 or less. Silver plans have the second-lowest costs and are the benchmarks used to calculate the tax credits. (Click for larger graphic)

Open enrollment is usually open for only six weeks at the end of a year, except for those who experience a “qualifying life event,” like getting married or losing a job. The enhanced subsidies, along with several other health-related provisions, were authorized under the $1.9 trillion relief-and-stimulus law and are aimed at making coverage more affordable for people who already have marketplace coverage, who are uninsured or have lost their employer coverage.

It also limits the amount a person would pay for a plan to 8.5% of household income, down from 9.83%. The federal government picks up the slack. The new rules remove that cap for two years and allow people with incomes above 400% of the poverty level ($51,040 for an individual) to be eligible for the enhanced subsides.

The Kentucky Center for Economic Policy reports that the relief bill’s provisions mean that many who earn between 139% of the poverty level ($17,900 for an individual) and 150% of the federal poverty level ($19,320 for an individual) can find plans with zero premiums. In Kentucky, anyone earning up to 138% of the federal poverty line qualifies for Medicaid, which is free of charge. For example, Kaiser Health News reports that a typical single person who makes $30,000 a year will pay $85 per month for a silver plan instead of $195, according to an analysis by the Center on Budget and Policy Priorities. A family of four making $75,000 will pay $340 rather than $588 per month for similar coverage, the analysis found.

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