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Your guide to buying affordable health insurance

Open enrollment for 2020 starts November 1, but you may still be able to buy coverage in the meantime. Here's what you need to know to buy a plan that's right for you.

Buying affordable health insurance for 2019 – and 2020

The Affordable Care Act’s annual open enrollment period for 2020 coverage starts November 1 and ends December 15 in most states. But while that annual open enrollment for most people in the individual market is several months away, millions seeking coverage will still find that they’re not out of coverage options right now.

Open enrollment for 2020

2019 Obamacare open enrollment guideThe start of open enrollment for 2020 ACA-compliant coverage is a little more than two months away, but it’s actually not too early to start considering your coverage options.

If you think it’s likely you’ll be eligible for a subsidy, be sure to familiarize yourself with the the basics of ACA subsidies. You’ll want to make sure that you get the maximum subsidy but also that you understand your options for claiming your subsidy – and the possibility that your choice could make it more likely that you’ll end up repaying some or all of your subsidy.

It’s also worth taking a moment to preview changes in open enrollment for 2020 coverage – including the usual rate changes, as well as actual marketplace changes. (Nevada is switching to its own enrollment platform.) It’s all in our updated Insider’s Guide to Obamacare’s 2020 Open Enrollment.

Extended eligibility thanks to qualifying events

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

How hard is your state fighting to preserve or strengthen the Affordable Care Act’s provisions? See the state-by-state tally.

If you have a qualifying life event, you may still have an opportunity to enroll in an ACA-compliant plan (or switch to a different plan) before open enrollment for 2020 coverage.

As our updated Insider’s Guide to Obamacare’s Special Enrollment explains, there’s a long list of qualifying events that could trigger a special open enrollment window for you. Among them:

Given the premium increases for 2019, it’s essential for anyone who is eligible for premium tax credits – or who might be eligible with an income fluctuation later in the year – to enroll through the exchange if and when they have a special enrollment period.

Depending on your household income, you may still be eligible for premium tax credits (aka, premium subsidies) and possibly cost-sharing reductions (CSR, aka, cost-sharing subsidies). Don’t sign up for an off-exchange plan and miss out on the possibility of much more affordable premiums via a tax credit.

Without a qualifying event, health insurance is not available outside of open enrollment. (Nevada is an exception: off-exchange plans in Nevada are available for purchase year-round, but the carrier can impose a 90-day waiting period before coverage takes effect).

Alternatives to ACA-compliant coverage

Short term policy availability by state.

Because ACA-compliant plans offer a long list of coverage protections – and the potential for coverage subsidies – we encourage our readers to explore ACA-compliant coverage options first. At the same time, we do recognize that there is a segment of the individual market population that can’t or won’t purchase ACA-compliant coverage:

  • Millions of Americans are caught in the coverage gap in states that haven’t adopted the ACA’s Medicaid expansion.
  • Many Americans are stranded by the family glitch, which makes them ineligible for subsidies.
  • Other Americans with incomes above 400 percent of the poverty level – and thus ineligible for the ACA’s subsidies – simply can’t afford the coverage costs of ACA plans.

The good news: there’s a wide range of short-term health coverage available that could provide a temporary safety net until these consumers get access to less expensive and more comprehensive coverage.

New rule makes longer short-term coverage easier to buy

Consumers who are unable to afford ACA-compliant coverage can now purchase short-term coverage with a much longer duration in many states. Federal regulation changes in late 2018 made it possible for many buyers to purchase a short-term plan with an initial duration of nearly a year – with renewal options that allow the plan to remain in force for up to three years.


Texas judge’s ruling does not change anything about 2019 coverage

On December 14, 2018, a federal district court judge in Texas ruled that the entire ACA is unconstitutional. This was not unexpected, and his ruling had been anticipated for several weeks.

The plaintiffs in the lawsuit (18 Republican attorneys general and two Republican governors) argued that because the ACA’s individual mandate penalty no longer exists after the end of 2018, the rest of the ACA is no longer constitutional. This is certainly a stretch, from a legal perspective, but the judge agreed with the plaintiffs.

Despite the headlines about the ACA being ruled unconstitutional, it’s important to understand that this case is far from over and could eventually make its way to the Supreme Court. Shortly after the ruling was announced, CMS Administrator Seema Verma tweeted that “the exchanges are still open for business” and that “there is no impact to current coverage or coverage in a 2019 plan.”

A guide to individual and family health insurance

For decades, we have recognized that the individual health insurance market continues to be a source of confusion for many consumers. And since 1994, this web site has been a guide for consumers seeking straightforward explanations about the workings of individual health insurance – also known as medical insurance.

Within this site, you’ll find hundreds of articles loaded with straightforward explanations about health insurance – and the health law – all written by a team of respected health insurance experts.

Our most popular resources include:


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.