What are the deadlines for the ACA’s open enrollment period?

Q. What is the deadline to enroll in 2022 ACA-compliant health insurance coverage in the individual market? Is 2021 coverage still available?

A. Open enrollment for 2022 health coverage starts nationwide on November 1, 2021. In most states, it will end January 15, 2022, although enrollments will need to be completed by December 15 to have coverage effective January 1 (enrollments completed between December 16 and January 15 will have coverage effective February 1 instead).

The January 15 end date includes a one-month extension that has been added by the Biden administration. For the past several years, open enrollment has ended on December 15, but the January 15 deadline will be used from now on.

California, Colorado, and DC have permanently extended ACA open enrollment

As noted above, most of the fully state-run exchanges have extended open enrollment for 2022 coverage until at least January 15, 2022. And some, like New York, have consistently extended open enrollment until the end of January. But three have specifically implemented regulations or legislation to codify an extended open enrollment period:

• California: November 1 – January 31. California enacted legislation in 2017 and again in 2019 that permanently establishes different enrollment dates within the state, both on and off-exchange. Open enrollment for 2022 health plans will begin November 1, 2021 and will continue through January 31, 2022. California’s enrollment schedule had varied in previous years, but this three-month window, from the beginning of November through the end of January, will be the permanent enrollment window going forward.
• Colorado: November 1 – January 15. Colorado’s Division of Insurance has also permanently extended open enrollment. The state finalized regulations in late 2018 that call for an annual special enrollment period, running from December 16 to January 15, that is added to the end of open enrollment each year. So open enrollment in Colorado will effectively last 2.5 months for all future enrollment periods (November 1 to January 15). Plans selected between December 16 and January 15 must take effect no later than February 1.
• DC: November 1 – January 31. DC’s exchange board voted unanimously to permanently implement an open enrollment window that runs from November 1 to January 31.

State-run exchanges have some flexibility on open enrollment schedule

The 2017 market stabilization rule noted that the November 1-December 15 open enrollment period would apply in every state in the fall of 2017. However, they also noted that some state-based exchanges — there are 15 of them as of 2021, and an anticipated 18 as of 2022 — might have experienced logistical difficulties in getting their systems ready for the new schedule on a fairly tight timeframe.

As such, the market stabilization rule clarified that state-based exchanges could use their own flexibility to “supplement the open enrollment period with a special enrollment period, as a transitional measure, to account for those operational difficulties.” Since then, the majority of the state-based exchanges have opted to extend open enrollment for most years, and they continue to have flexibility with the enrollment schedule going forward.

As noted above, New Mexico,  Maine, and Kentucky plan to have their own enrollment platforms by the fall of 2021. Fully state-run exchanges are the only ones with the ability to extend open enrollment on their own (in the other states, the decision has to come from CMS, since the extension has to be issued via HealthCare.gov), and most of them have been choosing to do so each year. But now that HHS has extended the HealthCare.gov deadline to January 15, many of the state-run exchanges are likely to use that date rather than issue additional extensions, as most of them tend to end their enrollment windows by mid-January in most years.

Outside of ACA’s open enrollment window, enrollment’s only available with a qualifying event

After open enrollment ends, people can normally only purchase coverage if they have a special enrollment period triggered by a qualifying event such as:

• Marriage (since 2017, this generally only applies if at least one spouse already had coverage before the wedding, although there are some exceptions),
• Becoming a U.S. citizen,
• Birth or adoption,
• Involuntary loss of other health coverage.
• A permanent move to an area where new health plans are available (since July 2016, this only applies in most cases if you already had coverage prior to your move).
• Here’s a complete guide to qualifying events in the individual market, and their associated special enrollment periods.

Regardless of whether you purchase insurance through the exchange or off-exchange, the annual open enrollment window applies, and special enrollment periods are necessary in order to enroll at any other time of the year.

The COVID/American Rescue Plan special enrollment periods in 2021 are an exception to the normal rules, in that qualifying events were/are not necessary in order to use these enrollment windows.

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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.