Kaiser Family Foundation estimates that about 15 million people are eligible for ACA coverage right now, and about 9 million of them could qualify for free or reduced-cost subsidized premiums. Those subsidies are available to people with incomes up to 400% of the federal poverty level (about $51,500 for one person or $106,000 for a family of four). In some cases, the highest level “gold” plans will be the most affordable option for people, thanks to an unintended glitch with which the Trump administration tried to sabotage the law.
The Biden administration’s commitment to getting the word out about this open enrollment is critical after four years of Trump sabotage in which no effort was made to let people know they were eligible. In fact, new enrollments have dropped every year since 2016. “There are a lot of uninsured people who even before COVID were eligible for either hefty marketplace subsidies or for Medicaid and not aware of it,” Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms, told NPR.
There are a few pitfalls to be aware of in shopping for a plan, or in some cases not shopping for one. If you’ve purchased an ACA plan previously and allowed yourself to auto-enroll in it again, now is a good opportunity to reevaluate and see what other potentially better options are available to you. But for new shoppers, the key thing is to not let the price tag fool you. Thanks, again, to Trump sabotage, there are junk options out there on the market that Biden hasn’t yet been able to do away with. Use the “find local help” tool at Healthcare.gov or call (800) 318-2596 to steer away from those plans.
Take the advice of Laura Packard, executive director of Get America Covered: “If a plan looks too good to be true, be skeptical.” As she says, “Human nature is to pick the cheapest one,” but in this case you might not get the full coverage you need—weigh the cost of monthly premiums against what you’re likely to spend in out-of-pocket expenses, especially for family members with chronic conditions that require frequent care or medications. Again, there is now going to be assistance from the federal government to help in figuring that stuff out.
That’s right now. The COVID-19 relief plan Congress is planning on passing in the next month will do more to make health insurance under the ACA more available and affordable. Biden referred to that in a statement Monday. “It will increase federal subsidies and decrease premiums in order to ensure that no one pays more than 8.5% of their income to purchase meaningful and comprehensive health coverage,” he said. “And it incentivizes states to expand coverage to an additional four million people with low incomes, and provides states the opportunity to extend coverage for a year to low-income women who have recently given birth.”
But for now, making sure everyone who lost coverage during this pandemic knows that they can sign up is the key. So don’t be surprised if you start seeing this in your web surfing: