November 8, 2022 by Natalie Cochran
2023 Open Enrollment for Affordable Care Act Coverage is November 1 – January 15, 2023
Overview
Most Affordable Care Act Coverage Plans will stay the same, leading into each new year. However, new rules implemented this past year will affect coverage in 2023, reducing your cost. If you haven’t been able to find a plan, or this is your first-time shopping for an affordable health plan, we will go over what you need to know before you choose one. Keep in mind, if you want your plan to begin on January 1, 2023, you will need to enroll between now and December 15, 2022. However, if you haven’t found a plan by December 15, you can still enroll by the final due date, January 15, 2023.
What is the Affordable Care Act (ACA)?
The ACA is a law enacted in 2010, which increases health insurance coverage for the uninsured. The law has three primary goals:
- Make affordable health insurance available to more people and provide consumers with premium tax credits that lower costs for households with incomes between 100 percent and 400 percent the federal poverty level (FPL);
- Expand the Medicaid program to cover all adults with income below 138 percent of the FPL; and
- Support innovative medical care delivery methods designed to lower the costs of health care.
Changes in qualifying for subsidies (financial assistance).
A subsidy is financial assistance that helps someone pay for something and does not have to be paid back. Under the new rules, families who were denied federal assistance in the past years to help them purchase ACA coverage may now qualify.
Preventative care costs
The ACA does not allow patients to be billed for various services, such as screenings, certain tests, vaccines, and drugs. These benefits will remain the same. If you ever have any doubt as a policy holder, you can check your insurance plan to verify covered benefits.
Will your premium increase?
Some health insurers are raising premium rates for people with ACA plans or employer coverage. Those who receive subsidies for their ACA plans will not undergo a higher premium.
People who earn up to $20,385 for an individual and $27,465 for a couple can get an ACA plan with no monthly premium. According to NPR, “consumers who earn up to $54,360 for an individual and $73,240 for a couple get sliding-scale subsidies to help offset premium costs. And the premiums for ACA plans purchased by people with higher incomes than that are also capped; according to the rules, they will need to pay no more than 8.5 percent of their household income toward premiums.”
Employees with job-based insurance can set the amount they must pay towards health coverage, and employers can take out money in their employees’ paychecks to adapt to the premium increases. Anyone whose share of their job-based coverage is expected to exceed 9.12 percent of their income in 2023 can check now to see if they qualify for a subsidized ACA plan instead.
Coverage will not end even if you owe
If you owe money to insurers or the IRS, your coverage will not end. Before COVID-19, people who failed to report the correct subsidy amount on their tax return based on the income they received would lose eligibility for a subsidy during the next enrollment period. Since COVID-19 issues at the IRS are still ongoing, consumers will still have active coverage. Insurers can no longer deny coverage to people or employers who owe past-due premiums for previous coverage due to COVID-19 issues.
Lone Star Legal Aid’s Financial Assistance and Public Benefits Unit can help individuals and families denied Medicaid, Chip, Medicare, and/or other Federal Health Coverage Plans. If you or someone you now need legal help, you can apply by visiting www.LoneStarLegal.org or calling 1-800-733-8394.
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Lone Star Legal Aid (LSLA) is a 501(c)(3) nonprofit law firm focused on advocacy for low-income and underserved populations by providing free legal education, advice, and representation. LSLA serves millions of people at 125% of federal poverty guidelines, who live in 72 counties in the eastern and Gulf Coast regions of Texas, and 4 counties in Southwest Arkansas. LSLA focuses its resources on maintaining, enhancing, and protecting income and economic stability; preserving housing; improving outcomes for children; establishing and sustaining family safety, stability, health, and wellbeing; and assisting populations with special vulnerabilities, like those with disabilities, the aging, survivors of crime and disasters, the unemployed and underemployed, the unhoused, those with limited English language skills, and the LGBTQIA+ community. To learn more about Lone Star Legal Aid, visit our website at www.LoneStarLegal.org.
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