Affordable Care Act Open Enrollment Guide for 2023


WRITTEN BY: Craig Sturgill

UPDATED: NOVEMBER 02, 2022 | 1 MIN READ

Fall’s arrival puts Americans just a few months away from the arrival of the (ACA) Affordable Care Act Open Enrollment period, where anyone can sign up for health insurance. Read on to learn more about Open Enrollment, preparing, and getting affordable healthcare coverage.

What is Affordable Care Open Enrollment?

The Affordable Care Act is known as the ACA or Obamacare. Enacted in 2010, it improves access to healthcare for millions of Americas and helps lower costs for healthcare plans. One of the ACA’s best features is its enrollment period, which occurs at the same time every year.

The Affordable Care Act’s Open Enrollment period is the window where you can sign up for health insurance through a state or federal health Marketplace. You and your family can only sign up for ACA health insurance on the Marketplace during this time, except if you meet specific criteria.

Open Enrollment for 2023 begins November 1 and runs until January 15. Certain states vary with enrollment length.

Open Enrollment by State

Not all states adhere to the same Open Enrollment deadline for their health insurance Marketplace. The following states offered an extended enrollment period and will likely be for 2023.

  • California (ends January 31)
  • Massachusetts (ends January 23)
  • New Jersey (ends January 31)
  • New York (ends January 31)
  • Rhode Island (ends January 23)
  • Washington DC (ends January 31)

Special Enrollment Periods

If you experience a qualifying life event, you may enroll for ACA coverage outside the Open Enrollment period under Special Enrollment. Special Enrollment may apply if you experience any of the following:

  • The birth, adoption, or foster of a child
  • A marriage
  • A divorce or separation which results in the loss of healthcare coverage
  • A new move to a new state or zip code (varies)
  • Relocate for school or seasonal employment
  • Relocation to the US from a foreign country or US territory
  • The death of a family member on the Marketplace
  • Move from or to a shelter
  • Loss of health insurance of any Marketplace-covered member
  • Loss of employer-provided health insurance
  • Loss of parents’ insurance after age 26

You may enroll up to 60 days before or 60 days after the qualifying life event for Marketplace coverage.

How Do You Participate in the Affordable Care Act Open Enrollment?

If you need health insurance and don’t meet Special Enrollment requirements, you must wait until Open Enrollment. If it’s your first time signing up for health insurance with the ACA, you can visit Healthcare.gov to start your application. Healthcare.gov is the federal government’s website for the Affordable Care Act.

When you apply for a health insurance plan through the Marketplace, your calculated premium cost depends on your household income and your family size. Under the ACA, you meet eligibility for lower premiums with a premium tax credit or a subsidy.

Subsidies apply to individuals or families with incomes between 100% and 400% of the federal poverty level. Your income determines the tax credit amount.

You may also meet eligibility for a cost-sharing reduction. These are only available for Silver Marketplace plans and help save on out-of-pocket costs, deductibles, and copayments.

State-Run Healthcare Marketplaces

Not every state uses the federal Marketplace for ACA health coverage. The following states feature a state-run Marketplace for health insurance coverage.

Medicaid and CHIP Enrollment

Enrollment for Medicaid and CHIP (Children’s Health Insurance Program) occurs any time of year. States vary in their names for these programs, but all states offer them.

Medicaid and CHIP recipients are low-income families, children, pregnant women, the elderly, and those with disabilities. Depending on the state, individuals under a certain income may be eligible for Medicaid. Medicaid and CHIP participants receive free or low-cost healthcare.

Enrollment for Medicaid and CHIP occurs through Healthcare.gov or the state’s Medicaid agency. The District of Columbia and 39 states feature Medicaid expansions, which offer eligibility for Medicaid services to more residents.

Changes for The Affordable Care Act Open Enrollment in 2023

The ACA, as it stands, features the family glitch, which may make health insurance unaffordable for many Americans.

If an individual’s employer offers health insurance, the ACA only considers the affordability or cost of the health plan for the employee, not the family.

However, if an employee has access to employer-provided coverage, their household is ineligible for subsidies.

President Biden proposed a solution to end the family glitch and improve affordability for family plans through the Marketplace.

This projected fix involves the Department of Health and Human Services (HHS) and the Income Revenue Service (IRS). Healthcare experts expect the finalized proposal in December 2022.

The Biden administration also addressed the so-called subsidy cliff, where a slight household income increase over the 400% poverty level limit would eliminate subsidies for Marketplace insurance.

The American Rescue Plan (ARP) eliminates the subsidy cliff, and subsidies gradually decrease with increased income. In addition, the Inflation Reduction Act extends the current subsidy enhancements from ARP to 2025.

FAQs

Is the Affordable Care Act still in effect for 2022?

Yes. The ACA is still in effect for 2022 and beyond.

Who qualifies for the ACA?

Unincarcerated citizens or those lawfully present in the United States may enroll in an ACA healthcare plan.

What are the benefits of the Affordable Care Act?

The Affordable Care Act offers health insurance to people without access to employer-provided healthcare. It also helps low-income families and self-employed individuals find affordable healthcare coverage.

The ACA requires insurers to cover preventative care, such as screening and diagnostics, at no cost. Improved access to these medical services encourages individuals and families to seek care when needed.

What are the advantages of the ACA?

The ACA forbids health insurers from denying you coverage or charging a higher premium based on a pre-existing condition. The legislation also includes a guaranteed issue, where health insurers must offer a policy regardless of an individual’s health condition.

With the ACA’s rules, individual and group health insurance plans can’t discriminate with a higher premium based on their sex or gender.

It also lets applicants choose the level of health coverage based on benefits, premiums, and coverage options. The ACA expands Medicaid access to millions more Americans.

What is the penalty for not having healthcare coverage?

You won’t have a penalty for lack of health insurance unless you live in a state that mandates health coverage.

How much does the ACA cost?

ACA cost varies by individual and family. Your premium amount depends on any tax subsidies you may receive, as well as your household size and income.

When is the Affordable Care Act open enrollment?

The window for ACA Open Enrollment is November 1 through January 15. A few states feature extended Open Enrollment.

How much does it cost to purchase ACA health insurance?

Your costs or premium varies based on income, family size, and eligibility for credits or subsidies.

Get Insurance Today

Are you interested in a healthcare plan? It’s challenging to navigate your options, but comparing various plans’ coverage, premium, and benefits is essential. You want to make the right decisions for your family with low out-of-pocket costs. Make sure you find the best rates by using our easy online tool