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What’s in our 2021 Guide to Open Enrollment?

Our guide to buying coverage for 2021 is loaded with tips for finding plans that fit your needs and budget – even before enrollment starts

Obamacare open enrollment dates and more:

What you need to know about open enrollment for 2021 coverage:

  • Early indications are that rate changes will be modest for 2021, with a mixture of small increases and decreases.
  • Your plan will take effect January 1, 2021. If you want coverage between now and then, consider a short-term plan.
  • Premium subsidies will continue to keep pace with the cost of the benchmark plan in each area.
  • If you’re eligible for cost-sharing reductions, you’ll continue to receive them.
  • In most states, there won’t be a penalty for being uninsured in 2021, but you still need coverage!
  • Don’t expect widespread promotion of open enrollment from the Trump Administration.

The Affordable Care Act, also known as Obamacare, is still making headlines and causing confusion. But after two years of carriers exiting markets and fairly steep rate increases, we saw an influx of carriers joining the exchanges for 2019 – or rejoining, after a previous exit – and average rate increases that were substantially smaller than they were for 2017 and 2018. And the same thing happened in 2020, with insurers joining the exchanges in many states and a very slight average rate decrease nationwide.
Although rate proposals for 2021 are only available in a handful of states thus far, they’re shaping up to be fairly modest, with an average proposed increase of less than 3 percent.
Open enrollment for 2021 coverage will run from November 1, 2020 to December 15, 2020 in most states (California, Colorado, and DC have permanently extended their open enrollment periods, Pennsylvaina’s new exchange will extend open enrollment, and other state-run exchanges are likely to also issue extensions to the enrollment deadline for 2021 coverage.
For most enrollees, the enrollment process will be very similar to how it worked for 2020. But Pennsylvania will switch to its own enrollment platform (instead of HealthCare.gov) and New Jersey plans to also run its own enrollment platform.
Here’s what to keep in mind as we head towards open enrollment for 2021:

All plans will take effect on January 1, 2021

When you purchase coverage during open enrollment 2021, the effective date will be January 1, 2021. If you already have an individual-market plan and you’re picking a different one during open enrollment, your current plan will end on December 31 (assuming you continue to pay all of your premiums when they’re due) and the new plan will take effect seamlessly the following day.
But if you’re uninsured, it’s important to understand that you could have to wait up to two months from the time you enroll until the time your new plan takes effect. If you’re in that situation and fairly healthy, a short-term plan can bridge the gap for you. Short-term plans are available in most states, and the coverage can take effect as soon as the day after you purchase your plan. So if you’re enrolling in an ACA-compliant plan on November 1, you can also enroll in a short-term plan on the same day. Your short-term plan will cover you until the end of the year, providing peace of mind just in case you end up with an unexpected emergency before the end of the year (you can click on your state on this map to see how short-term plans are regulated and which options are available to you).

Premium subsidies will keep pace with the cost of benchmark plans

The ACA’s premium subsidies are designed to increase or decrease to keep pace with the cost of the benchmark plan in each area. As premiums grow, so do premium subsidies (and vice versa… if premiums shrink, subsidies also get smaller). But starting in 2018, premium subsidies became disproportionately large in many areas, due to the way states and insurers handled the loss of federal funding for cost-sharing reductions (CSR).
That “silver loading” approach was widely used in 2019 and 2020, and will continue to be widespread in 2021, so don’t pass up the opportunity to get a subsidy! [HHS had indicated that they were considering the possibility of new federal rules, possibly starting as soon as 2021, but the budget bill that was passed in late 2019 ensured that silver loading would continue to be an option for insurers in 2021 (states and insurers are not required to utilize silver loading; WV, IN, and MS still do not). So for 2021 at least, nothing is changing about silver loading, meaning that premium subsidies are still disproportionately large in many areas of the country.]
Even if you’ve checked your eligibility before, make sure you do so again for 2021. As the poverty level rises each year, the income cap on subsidy eligibility also rises; it will reach $51,040 for a single person and $104,800 for a family of four in 2021 (the prior year’s poverty level numbers are used, so 2020 numbers are used to calculate 2021 subsidy amounts).
The short story: Shop around during open enrollment 2021. You might find that subsidies are larger in your area than they were in the past, but you could find that they’re smaller, depending on how benchmark premiums are changing. And in order to avoid an increase in the portion of the premium that you pay, you might find that you need to switch to a different plan for 2021.

If you’re eligible for cost-sharing reductions, you’ll continue to receive them

The federal government still isn’t funding cost-sharing reductions (CSR), but insurers and state regulators figured out a workaround (silver loading), and its use will continue be widespread for 2021. The details are explained here, but the short story is that the cost of CSR is being added to silver plan premiums in most states, and the CSR benefits themselves continue to be available in every state.

No penalty for being uninsured in 2021, but you still need coverage!

The ACA’s federal individual mandate penalty has been $0 since the start of 2019, and that will continue to be the case in 2021. People who are uninsured will not face a penalty, unless they’re in a state that imposes its own individual mandate.
Going without coverage isn’t wise, though, regardless of whether there’s a penalty. And open enrollment only comes around once a year. So if you were to find yourself uninsured and in dire need of medical care in mid-2021, you’d have to wait until 2022 to have coverage.
It’s true that there are more loosely-regulated coverage options available now, thanks to the expansion of short-term plans and the proliferation of health care sharing ministries. And there is no longer a direct penalty for relying on those types of coverage. But they all have drawbacks, so read the fine print carefully if you’re considering them.

Don’t expect the federal government to heavily promote open enrollment

In the fall of 2017, just before open enrollment for 2018 coverage, the Trump Administration announced drastic funding cuts for exchange marketing and enrollment assistance. And in 2018, the Administration again slashed funding for Navigator programs, down to just $10 million (it had already been reduced to $36 million in 2017). The lower funding level remained in place in 2019, and isn’t likely to increase for the duration of the Trump Administration. The administration can be expected to once again promote Medicare open enrollment but not individual market open enrollment.
But state-based exchanges and consumer advocates will continue to conduct outreach, and enrollment assistance will continue to be available throughout the country.
Of course, we know plan buyers have plenty of questions and concerns. The good news is that we’re again providing answers about enrollment in our updated Insider’s Guide to Obamacare’s Open Enrollment.
The expert behind the guide is contributor Louise Norris, whose stellar coverage of all things ACA has made her a respected source for major media who cover state health insurance marketplaces.

What’s in the updated guide?

Louise packed this year’s guide full of the information that matters most to plan buyers, including:

Have more enrollment questions?

If the guide doesn’t answer all of your questions, you’ll like find the answer you need in one of two dozen enrollment FAQs.

Helpful plan-buying tools

Here are just a few tools that can speed up your plan shopping:

What’s happening in your state?

Wondering what’s happening with premiums and plan availability in your state? Louise Norris has the latest updates on changes within your marketplace.

Find affordable health plans.

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