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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.

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Latest News & Topics


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 – December 9, 2020

A round-up of state and national headlines regarding individual health insurance and health reform

What are off-exchange health plans?

In most states, open enrollment ends in six days

Open enrollment for individual health plans is drawing to a close in most of the country. The deadline has been extended in 10 states and Washington, DC (although in most of those states, people still have to enroll by December 15 to have coverage that starts on January 1). But in the rest of the country, December 15 is the last day to enroll in an individual/family health plan for 2021. This is true regardless of whether you’re shopping in the health insurance marketplace or outside the exchange.

open enrollment 2021

Our 2021 Open Enrollment Guide: Everything you need to know to enroll in an affordable individual-market health plan.

A handful of states – Connecticut, Idaho, Maryland, and Vermont – run their own exchange platforms (and thus have the option to extend open enrollment) but have thus-far opted to keep the December 15 enrollment deadline for people buying 2021 plans. Any of those four states could still issue an extension, and we’ll update our deadlines page and our open enrollment guide if they decide to do so.

In the rest of the country, an extended deadline is only possible if the federal government agrees to allow it via HealthCare.gov. Some states have specifically asked for this, but HHS has not yet given any indication that they plan to offer an extension.

CMS announced last Thursday that a total of 2.9 million people had enrolled in 2021 coverage through HealthCare.gov during the first four weeks of open enrollment (through November 28), which is still trending higher than last year’s enrollment numbers. That accounts for 36 states; the other 14 states and Washington, DC, have their own enrollment platforms, and some of them have not yet publicized their enrollment data. But as of late November/early December, there were about 4 million confirmed enrollments nationwide – plus the enrollments in states that haven’t yet reported any data.

Biden selects California attorney general, ACA defender, to lead HHS

President-elect Joe Biden has chosen California Attorney General Xavier Becerra to be the secretary of Health and Human Services (a position currently held by Alex Azar). Becerra has spent years defending the Affordable Care Act from judicial attacks and pushing back against various health care measures implemented by the Trump administration.

California, led by Becerra’s office, has been the lead state in defense of the ACA in the California v. Texas (formerly Texas v. U.S.) lawsuit, which was argued at the Supreme Court last month.

The Kaiser Family Foundation has put together an extensive list of administrative changes the Biden administration can make in terms of healthcare reform. Assuming Becerra is confirmed by the Senate, we can expect that he’ll be leading the effort to implement many of those changes.

SCOTUS will hear arguments on legality of Medicaid work requirements

Last Friday, the Supreme Court agreed to take two cases (which are being combined) that are centered around the legality of Medicaid work requirements, with oral arguments expected to be set for late winter or early spring next year. These cases focus on the Medicaid work requirements that the Trump administration approved for New Hampshire and Arkansas, which were subsequently overturned by a federal judge.

Although work requirements have been approved in several states, none are currently in effect, due to a combination of court rulings and the COVID-19 pandemic. The Biden administration is unlikely to approve any of the pending work requirement waiver proposals, and could eventually rescind already-approved waivers, including the ones at the heart of the cases the Supreme Court has agreed to hear.

But the Court is the most conservative it’s been in several generations; if it rules that Medicaid work requirements are legal, that could come into play once a Republication administration is again in the White House.

Trump administration’s public charge rule changes blocked in DC and 18 states

There has been a lot of back and forth on the Trump administration’s changes to the “public charge” rule in recent weeks. Last month, the administration’s changes to the public charge rule were briefly vacated, nationwide, by a federal judge, but an appeals court stayed that decision just two days later, allowing the rule changes to continue to be implemented.

Then last week, the Ninth Circuit Court of Appeals blocked the implementation, but only in 18 states and Washington, DC. In the rest of the country, the Trump administration’s changes to the public charge rule – which adds Medicaid (and several other low-income assistance programs) to the list of benefits that can classify a person as a “public charge” – can continue to be implemented while additional lawsuits proceed in the court system.

California lawmakers introduce bills to provide Medicaid to undocumented immigrants

California already provides Medicaid (Medi-Cal) coverage, regardless of immigration status, to low-income residents under the age of 26. But as the 2021 legislative session got underway in the state this week, a pair of bills were introduced that would extend Medi-Cal eligibility to more low-income adults, regardless of their immigration status.

Senate Bill 56 would allow people age 65 or older to enroll in Medi-Cal if they meet the rest of the eligibility requirements other than immigration status. Assembly Bill 4 would go further, granting Medi-Cal benefits to any California resident, of any age, who would otherwise be eligible except for their immigration status.

The lawmakers who sponsored these bills noted that the COVID pandemic has been particularly brutal for undocumented immigrants – many of whom work in jobs that don’t allow for social distancing and that are essential for keeping the economy and food supply on track. They point out that providing health coverage for these essential workers is the right thing to do, especially given the state’s budget surplus.

Massachusetts AG sues insurer for misleading consumers

Massachusetts Attorney General Maura Healey announced this week that her office is suing HealthMarkets and two of its subsidiaries for misleading consumers. The lawsuit alleges that the insurers’ recent deceptive marketing practices are in violation of state laws, but also in violation also a court order from 2009, when HealthMarkets and two different subsidiaries had to pay more than $15 million after engaging in similar deceptive practices.

Healey’s office noted an extensive list of violations that stem from the companies’ efforts to essentially trick people into buying “supplemental health insurance products of very limited value” when the consumer wanted or needed major medical coverage instead. According to the lawsuit, more than 15,000 Massachusetts residents have been affected since 2011, and the companies have collected more than $43.5 million in premiums for the low-quality plans, while spending less than 20 percent of revenue on members’ claims.

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 insurance marketplace updates are regularly cited by media who cover health reform and by other health insurance experts.


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