Affordable Care Act
Understanding HealthcareAffordable Care Act 101
Nov 15, 2023
6 Minute Read

Affordable Care Act, Open Enrollment and More

Everyone deserves access to affordable, quality health care coverage. Americans of any income level should have access to Affordable Care Act (ACA) also known as Individual and Family Plans (IFP). This landmark health reform legislation, often called Obamacare, was passed by Congress, and signed into law by President Barack Obama in 2010.

Because the law is designed to provide access to healthcare coverage for all citizens regardless of income, ACA includes premium subsidies and cost-sharing subsidies designed to reduce the costs of coverage for Americans who qualify.  

When is ACA Individual and Family Plans open enrollment? 

Open enrollment for ACA plans starts November 1, 2023 and ends January 15, 2024. However, there are special circumstances that allow you to enroll in or change ACA health plans outside the yearly open enrollment period. We will highlight those later.

How do I enroll in an ACA plan?

There are a number of ways to sign up for ACA.  You can do the legwork on your own, with the assistance of an ACA navigator, or with an agent or broker. Here’s how to get started:

More about ACA you should know

Who qualifies?

ACA gives most uninsured people in the U.S. access to health insurance as long as they are U.S. citizens who live in the country, are not incarcerated, and are not covered by Medicare. People at all income levels can sign up for an ACA plan. ACA is designed to make healthcare affordable for all regardless of income—those who earn limited income qualify for financial assistance that will reduce their health insurance and healthcare costs. 

Who gets special reduced rates? If you have a household income between 100% and 400% of the federal poverty level (FPL), you may qualify for a premium tax credit or special subsidies that will reduce health insurance costs.  For your reference, FPLs can be found here.

How do consumers buy ACA health insurance?

Consumers can use ACA Health Insurance Marketplace (or exchanges) to easily compare the benefits and costs of qualified health plans. There are many plans available in the Health Insurance Marketplace. To help organize things a bit, all the plans are categorized under four level classifications—Bronze, Silver, Gold, Platinum—based on actuarial value and cost to the enrollee. Also, catastrophic plans are available to eligible enrollees.

Special enrollment for ACA

Sometimes life throws you a curve. There can be changes, often unexpected, that will impact your personal healthcare insurance. ACA has included a few circumstances that qualify for a special enrollment outside of the standard open enrollment period.

  • Life changing events – Certain life events, like losing your health coverage, moving, getting married, having a baby, or adopting a child, may qualify you to enroll outside the yearly ACA open enrollment period.
  • Recent loss of Medicaid or Children’s Health Insurance Program (CHIP) – If you recently lost (or will soon lose) your Medicaid or CHIP coverage because your income is too high or other changes that make you ineligible.
  • New special enrollment based on income – Individuals, families and children with certain incomes may qualify for health insurance through ACA (as well as Medicaid and CHIP). If eligible based on estimated household income, you can apply any time.

Not sure if any of these circumstances apply to your situation? You can find out here.

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