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13 qualifying life events that trigger ACA special enrollment
Outside of open enrollment, a special enrollment period allows you to enroll in an ACA-compliant plan (on or off-exchange) if you experience a qualifying life event.

Latest News & Topics

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Finalized federal rule reduces total duration of short-term health plans to 4 months
A finalized federal rule will impose new nationwide duration limits on short-term limited duration insurance (STLDI) plans. The rule – which applies to plans sold or issued on or after September 1, 2024 – will limit STLDI plans to three-month terms, and to total duration – including renewals – of no more than four months.
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The Scoop: health insurance news – August 5, 2020

Our August 5, 2020 round-up of state and national headlines regarding individual health insurance and health reform

The YesOn2 campaign collected 350,000 signed petitions to put a vote on Medicaid expansion on the Missouri primary ballot. Voters approved the expansion in Tuesday's election. | Image courtesy of Healthcare for Missouri

Missouri voters approve constitutional amendment to expand Medicaid

Voters in Missouri approved Amendment 2 yesterday, which will expand Medicaid eligibility in the state to cover adults up to age 64 with income up to 138 percent of the poverty level (a little under $18,000/year for a single person). The amendment calls for Medicaid expansion to take effect in Missouri as of July 2021. For the last several years, Republican lawmakers in Missouri have rejected federal funding to expand Medicaid, but voters approved the amendment by a margin of about 53-47. Oklahoma voters approved a similar measure in June, and four other states – Maine, Utah, Idaho, and Nebraska – have approved Medicaid expansion ballot measures in previous elections.

Colorado individual market insurers propose average rate increase of about 2% for 2021

Colorado’s eight individual market insurers – all of which offer coverage in Colorado’s state-run health insurance marketplace – have proposed an overall average rate increase of about 2 percent for 2021, with proposals that range from a decrease of about 12 percent to an increase of about 6 percent. Two of the insurers – Bright Health and Rocky Mountain Health Plans – are expanding their coverage areas for 2021. This year, Colorado has 22 counties where only a single insurer offers plans in the exchange; that will drop to 10 counties next year.

Two new insurers join Arkansas exchange for 2021; existing insurers propose average rate increase of about 7%

The Arkansas health insurance marketplace currently has four insurers offering plans, although three of them are part of the Centene/Ambetter family. For 2021, two new insurers – Oscar and Health Advantage – have filed plans to join the individual market in the state and offer plans in the exchange. Health Advantage is an affiliate of Arkansas Blue Cross and Blue Shield, as is one of the existing exchange insurers, USAble Mutual.

The four existing insurers have proposed an overall weighted average rate increase of about 7 percent for 2021. USAble Mutual has the largest market share and has proposed the smallest average rate increase, at less than 3 percent. But the other three insurers have all proposed average rate increases of at least 11 percent.

Covered California insurers propose record-low average rate increase of just 0.6%

Covered California published preliminary rate changes for its individual market this week, with an overall average rate increase of 0.6 percent. If finalized as is, that would amount to the smallest overall rate increase in Covered California’s history, and the second consecutive year with an average rate increase of less than 1 percent. Eleven insurers offer individual market plans through Covered California; five have proposed average rate increases while six have proposed average rate decreases. Two insurers – Anthem Blue Cross and Oscar – will expand their coverage areas for 2021. Virtually all California residents will be able to select from at least two insurers’ plans for 2021, and most will be able to choose from among four or more insurers.

New Jersey enacts legislation to create state-funded premium subsidies available for 2021

Last week, we told you about New Jersey legislation designed to replace the federal health insurance tax with a state assessment to generate revenue that will be used to make individual health insurance more affordable in New Jersey. A few days later, and only about three weeks after it had been introduced, the legislation was signed into law by Governor Phil Murphy.

The new law will allow the state to continue its successful reinsurance program, and also provide additional premium subsidies to exchange enrollees with income up to 400 percent of the poverty level. These enrollees already get federal subsidies to offset the cost of their health insurance, but the additional subsidies will make coverage more affordable and make it more realistic for people to purchase more robust coverage that will limit their out-of-pocket exposure when they need medical services. The state-based subsidies will be available for next year’s coverage, which can be purchased starting November 1.

Across 18 states and nearly 5 million enrollees, proposed average rate increase of about 2% for 2021

At ACA Signups, Charles Gaba is tracking average proposed health insurance premium changes for 2021 in an at-a-glance format. Across 18 states where individual market rate filings have been made public – accounting for nearly 5 million enrollees – Gaba has calculated a weighted average proposed rate increase of just over 2 percent. This could still change as the summer goes on, with more states being added, regulators weighing in on the proposed rates, and the constantly evolving impact of COVID-19. But for now, it’s shaping up to be another year of mostly modest overall rate changes in the individual market.

Oscar expands into four new states, grows coverage area in three other states

Oscar, which currently offers individual market coverage in 14 states, is once again expanding its coverage area for 2021. Oscar’s individual and family health plans will be newly available in select metropolitan areas in Arkansas, Iowa, North Carolina, and Oklahoma. And the insurer will expand its existing coverage areas in Colorado, Florida, and Pennsylvania. Coverage area expansions are shaping up to be fairly widespread again this year, with Friday Health Plans, Bright Health, UnitedHealthcare and various regional insurers also entering new states, and numerous insurers expanding their existing coverage footprints within states.

Bipartisan legislation introduced in Pennsylvania would sharply limit short-term health plans

Pennsylvania is among the states where short-term health plans are allowed to follow federal guidelines, although the state’s insurance commissioner has long been outspoken about the drawbacks of short-term health plans. Last week, bipartisan legislation was introduced in Pennsylvania’s House that would sharply restrict short-term plans. If enacted, the bill would limit short-term plans to 90 days and prohibit them from continuing into the coming year or taking effect in the year after they’re purchased. It would also impose a variety of other rules related to marketing, underwriting, and claims processing.

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

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