Buying affordable health insurance for 2019 – and 2020
- Open enrollment for 2020 coverage will run from November 1 to December 15, 2019 in most states.
- Six states will have longer open enrollment periods.
- Only Nevada allows residents to enroll outside of open enrollment without a qualifying event.
- Subsidies are critical to affordability, but familiarize yourself with options for receiving them – and avoiding repayment later.
- You can still buy 2019 coverage before open enrollment if you have a qualifying event.
- If you have a qualifying event, premium and cost-sharing subsidies are still available.
- For millions who can’t afford ACA-compliant coverage, short-term coverage could provide a temporary safety net.
- New federal short-term rules have expanded consumers’ access to short-term plans.
- The Texas court ruling to overturn the ACA does NOT affect your 2019 coverage.
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
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
- a permanent move
- marriage or the birth or adoption of a child
- loss of other coverage
- a change in your subsidy eligibility
- a change in your citizenship status
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
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.
- Does your state regulate short-term coverage? Read about plan and carrier availability.
- Read more FAQs about short-term health insurance.
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.
Our most popular resources include:
- a guide to Obamacare’s open enrollment
- a guide to ACA’s special enrollment periods
- (and a guide to the qualifying events that trigger SEPs)
- our Obamacare premium subsidy calculator
- our Obamacare penalty calculator
- frequently asked questions about insurance
- a health insurance glossary
- state-by-guides to the health insurance marketplaces
- an explanation of short-term health coverage options
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.