Thread by @charles_gaba

📣📣📣 Annnnd we're off! The 2023 #ACA Open Enrollment Period has officially launched!

Here's 1️⃣3️⃣ important things to remember before. you #GetCovered:
acasignups.net/22/11/01/its-t…

1. DON'T MISS THE DEADLINE!

While the final #ACA Open Enrollment deadline isn't until January 15th in most states, if you want your coverage to start on January 1st, you have to enroll earlier. Plus, Idaho's *final* deadline is in December.

Here's a table laying out the deadlines for every state. Note that some of these may be extended closer to the listed date...but don't count on that! #GetCovered sooner rather than later if possible.

2. MAKE SURE YOU DON'T ENROLL IN A JUNK PLAN OR GET SCAMMED!

Some brokers sell Non-#ACA compliant health plans called things like "short-term", "sharing ministry", "farm bureau" etc. I strongly advise sticking to plans w/full ACA protections sold via authorized ACA sites only.

Here's the official #ACA exchange sites for all states + DC. Note: There are also *authorized* 3rd-party broker sites which sell ACA-compliant plans as well such as @HealthSherpas, @BeW3LL etc:

CA: CoveredCA.com
CO: ConnectForHealthCO.com
CT: AccessHealthCT.com

DC: DCHealthLink.com
ID: YourHealthIdaho.org
KY: Kynect.KY.Gov
ME: CoverME.Gov
MD: MarylandHealthConnection.Gov
MA: MAHealthConnector.org
MN: MNsure.org
NV: NVHealthLink.com
NJ: GetCovered.NJ.Gov
NM: BeWellNM.com

NY: NYStateOfHealth.NY.Gov
PA: Pennie.com
RI: HealthSourceRI.com
VT: HealthConnect.Vermont.Gov
WA: WAHealthPlanFinder.org

ALL OTHER STATES: HealthCare.Gov

3. SWITCH TO ON-EXCHANGE!
If you're enrolled in an off-exchange plan, you can probably save THOUSANDS of dollars by switching to an ON-exchange plan!

Many people enrolled in #ACA-compliant individual market plans, but did so OFF-exchange because *at the time* they earned too much to qualify for financial help.

Well, THIS YEAR many of them DO qualify...but ONLY if they SWITCH to an ON-exchange plan via an ACA exchange.

Thanks to the #AmRescuePlan & #InflationReductionAct, there's no longer a hard income cap on #ACA subsidy eligibility. This means millions who didn't used to be eligible are now. I can't stress this enough: If you're enrolled off-exchange, check out your on-exchange options!

4. THE "FAMILY GLITCH" IS NO MORE!

Thanks to the Biden Administration, millions of *other* people who used to be ineligible for #ACA subsidies are newly-eligible in 2023 as well!

This one is wonky, but there are many households which haven't been eligible for #ACA subsidies due to a goofy definition of how "affordable" one members employer-based coverage was. The Biden Admin corrected this in such a way as to open up subsidies for many of these folks.

5. HIGH INFLATION MEANS HIGHER SUBSIDY THRESHOLDS.

High inflation isn't good of course, but it *does* mean that the Federal Poverty Level is going up a lot more than usual in 2023.

The #ACA's subsidy sliding scale is based in large part on your household income. As the FPL goes up year to year, so does the scale. This means a household which earns the same amount in 2023 as in 2022 will likely be eligible for more generous subsidies & savings next year.

Here's a table w/the maximum percent of your household income you'd have to pay for the benchmark Silver #ACA plan available in your area. If you earn <150%, your premiums are $0; 150 - 200% and it's no more than 2% of your income, and so on. NO ONE has to pay more than 8.5%.

6. TEN STATES HAVE *ADDITIONAL* SAVINGS *ON TOP OF* THE EXPANDED FEDERAL SUBSIDIES!

If you live in CO, CT, MN, MD, MA, NJ, ,NM, NY, VT or WA, you may qualify for extra savings!

COLORADO's Health Insurance Affordability Fund has extra savings for those earning 150-200% FPL, plus some help for undocumented immigrants as well.

CONNECTICUT is expanding their Covered Connecticut program for those earning up to 175% FPL.

MINNESOTA has their long-running MinnesotaCare program for those earning <200% FPL.

MARYLAND's Young Adult Premium Subsidy program offers extra savings to young adults aged 18 - 34.

MASSACHUSETTS offers ConnectorCare to households earning less than 300% FPL.

NEW JERSEY has expanded their Health Plan Savings program to those earning up to 600% FPL.

NEW MEXICO is launching their Health Care Affordability Fund to lower premiums even further for those earning up to 400% FPL.

NEW YORK's wildly popular Essential Plan is better than ever for those earning up to 200% FPL.

VERMONT has their VT Premium Assistance program for households earning less than 300% FPL.

Finally, WASHINGTON is launching their Cascade Care Savings program which reduces premiums down to $0 up to 250% FPL. They also offer $0 premiums for employees of child care facilities up to 300% FPL.

ALL OF THESE ARE ONLY AVAILABLE IF YOU ENROLL VIA THEIR STATE #ACA EXCHANGE!

7. MILLIONS OF PEOPLE ARE ELIGIBLE FOR *$0 PREMIUM* "SECRET PLATINUM" PLANS!

If you earn < 200% FPL, look for SILVER plans with the "CSR" or "Extra Savings" label.

Officially they're called "Silver CSR 94" or "Silver CSR 87" plans, but I call them #SecretPlatinum...

...because that's what they amount to: The dramatic reduction of deductibles, co-pays etc. via Cost Sharing Reduction savings means these plans cover ~94% or ~87% of typical medical expenses...similar to Platinum's ~90%.

*Without* CSR, a Silver plan covers ~70% of expenses.

8. MILLIONS OF NON-CSR ENROLLEES MAY STILL BE ABLE TO GET $0-PREMIUM *GOLD* PLANS!

There's a long, wonky story here, but the bottom line is that there's hundreds of counties where Gold plans cost less than Silver...in some cases as little as $0/mo after subsidies.

This is thanks to a pricing strategy known as #SilverLoading which has been around since 2018 but which has become more widely used since then. Here's a simple explainer for those interested:
acasignups.net/21/05/15/my-si…

In fact, last year TEXAS of all states--not exactly known for being #ACA-friendly--passed a bill UNANIMOUSLY to mandate #SilverLoading (aka Premium Alignment) thanks to a lot of hard work by a group of actuaries & legislators of all ideological stripes:
acasignups.net/22/04/27/not-j…

As @bjdickmayhew explains, the impact of mandating #SilverLoading in Texas (combined w/some other factors) will be dramatic in 2023:
balloon-juice.com/2022/10/27/zer…

9. THE INDIVIDUAL MANDATE PENALTY IS STILL AROUND IN SOME STATES!

If you live in California, DC, Massachusetts, New Jersey or Rhode Island, heads up!

Here's the penalty for NOT having #ACA Minimal Essential Coverage in each. Note that you may be eligible for an exemption from this based on hardship or for other reasons:

10. MANY STATES/COUNTIES WILL HAVE MORE CHOICES THAN EVER...BUT SOME MAY HAVE FEWER.

Every year some insurance carriers expand into new areas while others drop out of them. 2023 is no exception.

Major carriers like CIGNA, UNITEDHC and AETNA are expanding into new states...while startups like FRIDAY, OSCAR and especially BRIGHT are pulling out of others.

Even among the existing carriers, many are either adding new plans or phasing out current ones. Speaking of which...

11. STANDARDIZED PLANS ARE BACK (w/a big caveat).

A few states require all plans within a given category to have identical cost sharing (deductibles, co-pays, coinsurance) to simplify enrollee decision-making. HC.gov is mandating these in 2023...

...HOWEVER, these plans (known as "Easy Pricing" plans on HC.gov) are IN ADDITION TO existing #ACA plans.

In other words, you could have dozens of plans to choose from with *different* cost sharing, but can then filter out the non-standardized plans if you wish.

12. THE NAVIGATOR PROGRAM IS BACK AT FULL STRENGTH!

If all of the above sounds confusing, fear not: The Biden Administration has fully funded the #ACA Navigator program!

Last year the Biden Admin quadrupled the number of #ACA navigators--trained to help guide you through the often confusing process of health insurance enrollment. You can also get help from a qualified agent or broker. Go here to find assistance near you: localhelp.healthcare.gov/#/

13. FOR THE LOVE OF GOD, *DON'T* LET YOURSELF BE PASSIVELY AUTO-RENEWED!

I know the array of changes can be overwhelming & it's tempting to just let yourself be auto-renewed, but I strongly advise against it!

Even if nothing has changed at your end (same address, same income, same household size, etc), the plans, provider network & subsidies you qualify for could be VERY different next year (better or worse).

You may renew your current plan after all--but ACTIVELY SHOP AROUND first!

P.S. If you find this thread or my other work at ACA Signups useful & wish to support it, you can do so here, thanks! acasignups.net/support

P.P.S. I don't *currently* plan on leaving Twitter, but I'm also cross-posting over at Mastodon as well just in case. You can find me there at mastodon.social/@charlesgaba, but be warned that they may be a bit overwhelmed w/the flood of Twitter refugees at the moment...