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A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994.
Open enrollment for 2023 health coverage started Nov. 1 and ran through Jan. 15 in most states.
In the majority of the states, open enrollment for 2023 coverage ran through January 15, 2023. But some state-run exchanges have later deadlines, and in Idaho, open enrollment ended altogether on December 15, 2022.
Enrollments in most states needed to be completed by December 15, 2022 in order to have a plan that took effect on January 1. But there are several states where the deadline for a January 1 effective date was later:
In nearly every state, enrollments completed after December 15 (or the alternate deadline listed above, for states that differ) but before the end of open enrollment had a February 1 effective date, although there are generally a few states where a March effective date is possible during the latter part of open enrollment if the state allows the enrollment window to extend beyond mid-January.
Discuss your ACA coverage options – and your eligibility for money saving subsidies – with a licensed agent today. Call 1-866-687-1089
Enrollments in most states needed to be completed by December 15, 2022 in order to have a plan takes effect on January 1. But there were some exceptions:
The chart below shows the start and end date for open enrollment each state. Other than the states listed above, the deadline for a January 1 effective date was December 15, even in states that have extended final enrollment deadlines.
During the open enrollment period for 2022 coverage, enrollment reached a record high, with more than 14.5 million people signing up for coverage through the exchanges (marketplaces). The record-high enrollment was driven in large part by the subsidy enhancements created by the American Rescue Plan (ARP). And enrollment for 2023 was even higher, with 16.3 million marketplace enrollees by January 15 (open enrollment continued past that point in several states).
The ARP’s improvements to the ACA’s subsidy structure have allowed an unprecedented number of Americans to qualify for premium tax credits that are larger than they used to be. And the Inflation Reduction Act, signed into law in August 2022, extends the current subsidy enhancements through 2025.
So during the open enrollment period for 2023 coverage, the enhanced subsidies continued to be available. And depending on the price of coverage, subsidies have also continued to be available to households with income above 400% of the poverty level.
Enrollment assistance has been more available than ever in late 2022 and early 2023, thanks to the Biden administration’s historically large investment in Navigator funding.
In the fall of 2022, shortly before the start of the open enrollment period, the IRS finalized a fix for the “family glitch,” making some workers’ families newly eligible for premium subsidies in the exchange.
For 2022, additional insurers entered or expanded their presence in the marketplaces, increasing health plan options for consumers around the country. For 2023, there were once again numerous insurers that joined the exchanges or expanded their coverage areas, but there were also some insurers that exited the marketplaces in some states. Insurer exits and entries can result in changing benchmark premiums, which can change premium subsidy amounts. Here’s what you need to know about how that works.
Standardized health plans returned to HealthCare.gov for 2023, and continue to be available in several of the state-run exchanges.
And as of 2023, health plans will have to publicize their pricing for a list of 500 common medical services, which will help people comparison shop for medical care.
You can enroll in a health insurance plan online, over the phone, or in-person. But regardless of the method, if you’re enrolling in a plan through the exchange, you’re going to need to have the following information on hand for each enrollee:
In most cases, your coverage selected during open enrollment takes effect on January 1. But in most states, enrollments completed after December 15 will have coverage effective February 1 (there are some states where you could enroll after December 15 and still get a January 1 effective date). And in states where open enrollment continues into the latter half of January, it’s possible to have coverage effective March 1.
If you were already enrolled in an individual-market plan and you picked a different plan during open enrollment (in most cases, by December 15), your old plan ended on December 31, and your new plan took effect seamlessly on January 1, assuming you paid all of your premiums when they were due.
If you were uninsured and had to wait until January or February for your new plan to take effect, a short-term medical plan could bridge the gap for you, as long as you’re fairly healthy. 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 a short-term plan can provide peace of mind just in case you end up with an unexpected emergency before your new coverage takes effect.
But note that short-term plans should not be thought of as a viable replacement for regular individual major medical coverage. If you’re relying on one temporarily, you’ll definitely want to sign up for an ACA-compliant plan during open enrollment.
If you enroll during the open enrollment period but you also experienced a qualifying event, you may have been able to get coverage that took effect before the start of 2023. For example, if you got married and applied for coverage in November, you could have had a December 1 start date if you used your special enrollment period, whereas you’ll have a January 1 effective date if you just enrolled under the normal open enrollment period rules.
So if your special enrollment period overlaps with open enrollment, you might want to utilize your special enrollment period in order to get an earlier effective date. But keep in mind that the plan will then renew on January 1, which means you’ll have a nearly immediate rate change and potential benefits change for the new year.
If you didn’t enroll in an ACA-compliant health insurance plan by the end of open enrollment (January 15, 2023 in most states), your buying options will be limited until the next open enrollment starts in the fall of 2023.
Depending on the circumstances, there are various options for obtaining coverage, even after open enrollment ends:
Medicaid and CHIP enrollment are available year-round for those who qualify. If your income drops to a Medicaid-eligible level later in the year, you’ll be able to enroll at that point. Similarly, if you’re on Medicaid and your income increases to a level that makes you ineligible for Medicaid, you’ll have an opportunity to switch to a private plan at that point, with the loss of your Medicaid plan serving as the qualifying event that triggers a special enrollment period.
(Note that until April 1, 2023, states are not disenrolling people from Medicaid unless the enrollee requests it. But starting in April 2023, the pandemic-related Medicaid continuous coverage requirements will end, resulting in a significant number of people losing their eligibility for Medicaid. The loss of coverage will trigger a special enrollment period, allowing them to enroll in other coverage, either through an employer, the individual/family market, or Medicare, depending on what coverage they’re eligible to select.)
In September 2021, the Biden administration finalized a new monthly enrollment opportunity for people who are subsidy-eligible and whose household income doesn’t exceed 150% of the federal poverty level. This enrollment opportunity will remain in place for as long as the American Rescue Plan’s subsidy structure (which grants premium-free benchmark plans to people at this income level) remains in place. That’s at least through the end of 2025, thanks to the Inflation Reduction Act.
In some states, additional state-funded subsidies result in premium-free benchmark plans even at incomes above 150% of the poverty level. So there are a few states (NJ, NM, VT, and WA) that have opted to extend the low-income special enrollment opportunity to households with higher incomes. But there are also a few state-run exchanges (ID, MD, and NV) where the low-income special enrollment period does not appear to be available as of 2023.
Native Americans can enroll in plans through the marketplace year-round. Here’s more about special provisions in the ACA that apply to Native Americans.
If you have a qualifying event during the year, you’ll have access to a special enrollment period (SEP). Qualifying events include marriage (assuming at least one spouse already had coverage prior to the marriage), the birth or adoption of a child, loss of other minimum essential coverage, or a permanent move to a new geographical area where the available health plans are different from what was available in your prior location (assuming you already had coverage prior to your move).
Here’s a full guide to all of the qualifying events that trigger special enrollment periods in the individual market, including details about the specific rules that apply to each of them.
Under general federal rules, short-term health insurance plans can have initial terms of up to 364 days and a total duration of up to 36 months, including renewals. But the majority of the states have more restrictive limits on the availability of short-term plans, and those state limits supersede the federal rules.
You can visit our short-term health insurance page to check your state’s guidelines.
There is no federal government penalty for being uninsured in 2023, 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 for 2023. People who are uninsured do not face a penalty, unless they’re in a state that has its own individual mandate and a penalty for non-compliance. Four states and DC impose tax penalties for not having health insurance:
Yes! In every state, you can browse the available plans anonymously before you create an exchange account. If you want to see rates and plan options, the information is available – online, in-person, and by phone. Here are some tips for finding it:
There are several states that offer additional subsidies beyond the federal benefits provided by the Affordable Care Act. Some of these state subsidies reduce the premiums that people pay for their coverage, and some reduce out-of-pocket costs. Here’s a summary of what’s available for 2023:
If you were already enrolled in an ACA-compliant health plan through your state’s marketplace, was it possible to just let that plan automatically renew for 2023? In most cases, yes, assuming your plan continues to be available. But letting your plan auto-renew is not in your best interest.
Auto-renewal was an option for nearly all exchange enrollees for 2023, although there are some enrollees whose 2022 plan is no longer available in 2023 (for example, enrollees with Oscar Health in Colorado and Arkansas, and Bright Health enrollees in any state).
If you had a plan through the exchange that is no longer available in 2023, the health plan or the exchange (if the insurance company is exiting the area altogether) likely selected a new plan for you. This is better than becoming uninsured, but it’s always best to select your own replacement plan, rather than relying on an algorithm that an insurer or the exchange will use.
And even if your health plan continues to be available, relying on auto-renewal is not in your best interest. No matter how much you like your plan, it pays to shop around during open enrollment and see if a plan change is worth your while.
Here is why:
(Note that throughout the COVID pandemic, the exchanges have not discontinued premium tax credits for people who failed to reconcile a prior year’s premium tax credit with the IRS. The federal government announced in 2022 that this would continue to be the case for 2023, meaning that premium subsidies for 2023 are still available — assuming the person is still subsidy-eligible — even if the person hasn’t reconciled a prior year’s premium subsidy with the IRS. Starting with 2024 coverage, however, the government has proposed a rule change that would result in discontinued subsidies if the person has failed to reconcile prior premium tax credits for two consecutive years.)
Health insurance is complicated, and many people want or need personal assistance with the application process and with ongoing insurance utilization questions. To fill this need, there are a variety of assisters nationwide who are trained to guide people through the process of researching and enrolling in health plans, and some can provide ongoing support after the plan is purchased.
The health insurance Navigator role was created for the purpose of providing impartial education and outreach about the exchanges and exchange health plans, helping applicants determine whether they qualify for subsidies or Medicaid, and assisting them in the enrollment process.
Navigators are not permitted to recommend one plan over another or direct consumers towards a particular policy. Instead, their job is to provide general information that consumers can use to understand what’s available to them. Navigators are paid by state and federal grant programs, and they cannot be compensated by the insurance companies.
Certified application counselors (CACs) can also provide assistance with the enrollment process. They are similar to Navigators, but their role is more limited and their focus tends to be strictly on helping people enroll, without the more extensive assistance that some Navigators can provide.
The exchange designates local “CAC organizations” (health centers, faith-based organizations, colleges, etc.) and people who are affiliated with or employed by those organizations are eligible to serve as CACs. Navigators are funded through the exchange, but certified application counselors are not. Funding for the CAC program can come from a variety of state and federal sources though, including existing public health appropriations. And CACs themselves are often volunteering their time to help people enroll in health coverage.
Insurance brokers and agents who are certified by the exchanges can also explain plan details and help consumers determine subsidy or Medicaid eligibility, but – and this is a key difference – they can also make plan recommendations based on a client’s particular situation.
Agents and brokers continue to assist their clients after the plan is purchased, helping them sort out questions and problems regarding billing, utilization, claims, and appeals. Brokers and agents also generally carry errors and omissions insurance, and are licensed by their state department of insurance (this is in addition to their certification with the exchange; Navigators and CACs are trained and certified by the exchange, but are not licensed by the state insurance department).
For health insurance purposes, independent agents and brokers are virtually the same thing, although brokers may represent more carriers or offer different types of insurance products.
If your health insurance policy is not grandfathered but was in effect prior to 2014, your plan is considered a transitional health plan or “grandmothered policy.” These plans are not fully ACA-compliant, and were purchased between March 23, 2010 – when the ACA was signed into law – and the end of 2013.
This page offers a detailed overview of how grandmothered/transitional health plans are regulated and the specific rules that apply in each state.
As a general rule, even if you have the option to renew your grandmothered health plan, you should compare it with the available options in the exchange. You might find that you can get better coverage with a new plan, and possibly a lower premium, depending on whether you’re eligible for premium tax credits (most people are).
Legislation signed today provides substantial premium tax credits and cost-sharing reductions to Americans receiving unemployment benefits.
How the Affordable Care Act's subsidies are calculated, and who is eligible to receive them under the American Rescue Plan.
Open enrollment for 2023 ACA health coverage started nationwide on November 1. In most states, it will end on January 15, 2023.
Sweeping health reform legislation delivered a long list of provisions focused on health insurance affordability, consumer protections.