Thread by @charles_gaba

🎉 #HappyNewYear! 2023 #ACA Open Enrollment is still ongoing in 49 states + DC! Here's 13 important things to remember before you #GetCovered: #xp
acasignups.net/23/01/01/2023-…

1. DON'T MISS THE DEADLINE!

The final #ACA Open Enrollment deadline is Jan. 15th in most states, for coverage starting Feb. 1st (in a few states it's as late as Jan. 31st.) #xp

Here's a table laying out the deadlines for each state. Note that some of these may be extended at the last minute...but don't count on that! #GetCovered sooner rather than later if at all possible! #xp

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 via authorized ACA sites only. #xp

Here's every official #ACA exchange site: #xp

CA: CoveredCA.com
CO: ConnectForHealthCO.com
CT: AccessHealthCT.com
DC: DCHealthLink.com
ID: YourHealthIdaho.org*
KY: Kynect.KY.Gov
ME: CoverME.Gov

*(ID enrollment limited to SEPs)

MD: MarylandHealthConnection.Gov
MA: MAHealthConnector.org
MN: MNsure.org
NV: NevadaHealthLink.com
NJ: GetCovered.NJ.Gov
NM: BeWellNM.com
NY: NYStateOfHealth.NY.Gov
PA: Pennie.com
RI: HealthSourceRI.com
#xp

VT: HealthConnect.Vermont.Gov
WA: WAHealthPlanFinder.org

ALL OTHER STATES: HealthCare.Gov

You can also use *authorized* 3rd-party web brokers like HealthSherpa.com, W3LL.com or StrideHealth.com, which hook into the federal exchange. #xp

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! #xp

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. #xp

Thanks to the #AmRescuePlan & #InflationReductionAct, there's no longer a hard income cap on #ACA subsidy eligibility. This means millions who weren't eligible before are now.

I can't stress this enough: If you're enrolled off-exchange, check out your on-exchange options! #xp

4. THE "FAMILY GLITCH" IS (mostly) NO MORE!

Thanks to the Biden Admin., millions of *other* people who used to be ineligible for #ACA subsidies because one of them is eligible for (unaffordable for the whole family) employer coverage are newly-eligible in 2023 as well! #xp

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. #xp

5. HIGH INFLATION MEANS HIGHER SUBSIDY THRESHOLDS.

High inflation isn't good overall, of course, but it *does* mean that the Federal Poverty Level is going up a lot more than usual in 2023...which also means more financial assistance for more people. #xp

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 this year. #xp

Here's a table w/the maximum percent of your household income you 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%. #xp

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! #xp

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. #xp

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. #xp

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. #xp

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. #xp

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 #ACA EXCHANGES! #xp

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... #xp

...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. #xp

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. #xp

This is thanks to a pricing strategy known as #SilverLoading (officially "#PremiumAdjustment) which has been around since 2018 but which has become more widely used since then. Here's a simple explainer for those interested: #xp 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 #PremiumAlignment) thanks to a lot of hard work by a group of actuaries & legislators of all ideological stripes: #xp acasignups.net/22/04/27/not-j…

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! #xp

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: #xp

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. #xp

Big 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... #xp

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... #xp

...HOWEVER, these plans ("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. #xp

All of this can get confusing, but fear not, because...

12. THE NAVIGATOR PROGRAM IS BACK AT FULL STRENGTH!

The Biden Administration has fully funded & expanded the #ACA Navigator program! #xp

Last year the Biden Admin quadrupled the number of #ACA navigators--trained to help guide you through the 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/#/ #xp

13. This one is less relevant for 2023 for most people now that we're into January, but it's still good advice for future years: DON'T LET YOURSELF BE PASSIVELY AUTO-RENEWED!

I know it's tempting to just let yourself be auto-renewed, but I strongly advise against it! #xp

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

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

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! #xp acasignups.net/support