Open enrollment for the Affordable Care Act (ACA) health insurance marketplaces ends on Jan. 15, with most consumers having until then to choose a plan for 2022 that will best meet their medical needs.
As consumers review their insurance coverage and decide whether to make changes for 2022, they'll see not only more plans but also more affordable options as well, says Karen Pollitz, senior fellow at the nonpartisan Henry J. Kaiser Family Foundation.
"I think people who haven't looked in a while will be pleasantly surprised at how much more affordable the coverage is," Pollitz says. That is due mainly to the American Rescue Plan enacted in 2021 that temporarily expanded the federal subsidies available in the marketplace plans and increased the amount of the financial assistance for which consumers can qualify.
"If your income is one to one and a half times the [federal] poverty level, which is just under $20,000 a year for a single person, you can now get a free heath insurance policy that has either a zero or a very low deductible," Pollitz says. And the vast majority of Americans who sign up for ACA plans can expect to qualify for some federal subsidy. Also under the American Rescue Plan, consumers will not have to pay any more than 8.5 percent of their annual income for marketplace insurance plan premiums.
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These enhanced subsidies will be in place through 2022. Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services (CMS), told reporters on a Nov. 1, 2021 call that, under the terms of the proposed Build Back Better social spending framework, this added financial assistance would remain in place through 2025.
More plans with lower premiums
According to CMS most consumers will have four or more health plan choices for 2022. In all but 2 percent of counties across the country, there will be more than one available plan. That's down from 4 percent of counties in 2021.
Four out of 5 health coverage shoppers will be able to find a plan for under $10 a month, and a single person earning up to just over $50,000 a year will, on average, save $240 a month in premiums, according to CMS.
More than 12.2 million Americans currently get their health insurance through the federal and state marketplaces.
More time to sign up
There are three new state marketplaces. Kentucky, Maine and New Mexico join 14 other states and the District of Columbia with marketplaces of their own. In those states, consumers sign up for insurance through those local exchanges instead of the federal marketplace. You can still go to healthcare.gov to find your state's online exchange, and consumers in the new states should have received letters informing them of the change.
Six states and the District of Columbia have set their enrollment deadlines later than the extended federal cutoff: Massachusetts, Jan. 23; California, D.C., New Jersey, New York and Rhode Island, Jan. 31.
Most eligible for ACA subsidies
The vast majority of consumers who apply for coverage through the ACA are eligible for federal subsidies to help defray the cost of their monthly premiums.
The ACA provides two types of financial assistance: tax credits and cost-sharing subsidies. Eligibility is based on income, and historically more than 80 percent of people who get their insurance through the marketplaces are eligible for subsidies.
For 2022, you are likely eligible for a tax credit for premiums if your annual income falls within these ranges: $12,880 to $51,520 for an individual and $26,500 to $106,00 for a family of four. You can also qualify for a cost-sharing subsidy depending on your income and what level plan you select. Marketplace plans come in four tiers — bronze, silver, gold and platinum — with the bronze tier having the lowest premiums but the highest cost-sharing for care, and the platinum tier having the highest premiums but the lowest cost-sharing.
Healthcare.gov has a calculator to help you figure out if you qualify for a tax credit and/or cost-sharing subsidy and the amount you may qualify for.
More help available
Brooks-LaSure says full funding for navigators, trained individuals who provide free assistance in picking an ACA plan, has been restored, so consumers should find it easier to get help selecting and enrolling in a plan than in recent years.
More than 5,500 assisters, including trained navigators, application counselors and others, as well as over 48,000 agents and brokers, will be available.
CMS has also relaunched its Champions for Coverage program, which includes more than 2,100 local organizations that will provide outreach and education about the marketplace and how consumers can enroll in coverage.
The ACA hotline (800-318-2596) is available seven days a week, 24 hours a day. Consumers can also find local help through the healthcare.gov website.
Dena Bunis covers Medicare, health care, health policy and Congress. She also writes the “Medicare Made Easy” column for the AARP Bulletin. An award-winning journalist, Bunis spent decades working for metropolitan daily newspapers, including as Washington bureau chief for the Orange County Register and as a health policy and workplace writer for Newsday.