ACA Open Enrollment Deadlines

ACA Open Enrollment Deadlines

While health insurance hasn’t been mandatory at the federal level since January 1, 2019, some states require individuals to carry a policy in order to avoid a tax penalty. Even if your state doesn’t require you to have health insurance coverage, it is still a good idea to do so. While you may save money in the short term, not having health insurance becomes quite costly if you or one of your dependents is injured or suddenly falls ill. Under the Affordable Care Act, you can enroll in health insurance policies during a specific window each year.

What Are the Deadlines for the ACA’s Open Enrollment Period?

The simplest answer is that nationwide enrollment for health insurance plans for the 2022 year begins on November 1, 2021, and lasts until January 15, 2022. However, your personal circumstances or the state you live in may determine whether you have an extended window to fulfill your health insurance needs.

Is There Anyone Who Can Enroll in ACA-Compliant Health Plans During Any Time of the Year?

Most notably, anyone who is eligible for Medicaid or CHIP can enroll in an ACA-compliant health plan no matter what time of the year it is. New York and Minnesota each have their own Basic Health Programs that allow eligible individuals to enroll year-round as well. People who live in Connecticut and are part of the state’s new Covered Connecticut Program, or those who live in Massachusetts and qualify for the ConnectorCare Program can enroll through the end of the year, too. Alaska Natives and Native Americans can also enroll all year.

Recently, a new rule was finalized that allows those who earn up to 150% of the poverty level to enroll all year for the duration of the American Rescue Plan’s subsidy enhancements. Currently, the rule stands through 2022, but Congress is expected to extend it further.

Is ACA Enrollment for 2021 Coverage Still Available in Any State?

After open enrollment for 2021 ended, President Biden’s administration created a special enrollment period as part of the COVID/American Rescue Plan. The special enrollment period, which was available for anyone who was uninsured or who wanted to change plans, was available until August 15, 2021. Despite the end of the enrollment period, some circumstances do still allow for individuals to enroll in a healthcare plan. Some people who received unemployment compensation in 2021 are still eligible to enroll in a healthcare plan. Some states are also still allowing enrollment without a qualifying event.

In Washington, D.C., individuals can enroll through the end of the pandemic emergency period. In Minnesota, anyone who received unemployment in 2021 is still eligible to enroll. Individuals in Connecticut can enroll in a plan through October 31, while those in California, New Jersey, and New York can enroll through the end of 2021.

How Long Do I Have To Enroll in Individual, ACA-Compliant Health Insurance for 2022?

Individuals nationwide can start enrolling in health coverage plans for 2022 beginning November 1. In previous years, individuals only had until December 15 to complete the open enrollment process. However, an extension added by President Biden’s administration gives people in most states until January 15, 2022, to complete enrollment. Those who wish for their health coverage to take effect on January 1 will still need to enroll by December 15, 2021, however. Anyone who completes enrollment between December 16, 2021, and January 15, 2022, will have coverage beginning on February 1, 2022.

Do State-Run Exchanges Have Any Flexibility in Their Open Enrollment Schedules?

In 2017, the market stabilization rule took effect, noting that every state would have until December 15 for open enrollment that year. At the time, it was also noted that some state-based exchanges might have logistical difficulties when it came to readying their systems in such a tight timeframe. Due to this, the rule also clarified that state-based exchanges could be flexible by supplementing open enrollment with a transitional special enrollment period to account for the difficulties. Since then, most state-based exchanges continue to use that flexibility to extend open enrollment each year.

Although coverage for 2022 and future years now has an open enrollment window until January 15, state-run exchanges still have the flexibility to use an earlier deadline window, although it cannot be earlier than December 15 of each year. In 2021, only two states, Maryland and Vermont, kept the December 15 deadline. Both states did later reopen enrollment under the American Rescue Plan subsidies. Now that a nationwide deadline of January 15 is in effect, it is likely that most states will use that deadline rather than provide any additional extensions to their residents.

What Are the Open Enrollment Deadlines for State-Run Exchanges?

Currently, 18 states use state-based marketplaces, which means they perform all the marketplace functions for state residents. State-run exchanges can set their own deadlines for open enrollment, as long as those deadlines are not prior to December 15. These states also have the option to extend their open enrollment deadlines. State-run exchanges can make changes during the open enrollment window and sometimes provide last-minute extensions. As of now, the open enrollment deadlines are as follows:

  • December 15 (No Extensions) –Idaho and Maryland
  • December 15 –Connecticut
  • January 15 –Colorado, Kentucky, Maine, Minnesota, Nevada, New Mexico, Pennsylvania, Washington, and Vermont
  • January 23 –Massachusetts
  • January 31 –California, Rhode Island, New Jersey, New York, and Washington D.C.

Which States Have Permanently Extended Their Open Enrollment?

Two states have implemented legislation or similar regulations to extend their open enrollment periods permanently. California first enacted legislation to change its open enrollment period in 2017 and did so again in 2019. Although the state’s schedule used to vary each year, it no longer does so. Open enrollment for the 2022 year begins on November 1, 2021, and goes until January 31, 2022. This is the three-month window the state intends to use for every year going forward.

Colorado also permanently extended its open enrollment. The state’s Division of Insurance finalized its regulations in 2018. Open enrollment in the state lasts from November 1 to January 15 each year, with plans selected after December 15 taking effect on February 1. In addition to California and Colorado, Washington, D.C. permanently extended its enrollment window. Thanks to a unanimous vote by the city’s exchange board, enrollment in the area now runs from November 1 to January 31 every year.

Can Someone Enroll for Insurance Outside of the Open Enrollment Windows?

If someone does not enroll for an insurance plan before his or her state’s open enrollment ends, it typically means he or she cannot enroll until the following year opens. However, there are some exemptions to the rule, known as qualifying events. A qualifying event allows an individual or family to enroll in a health insurance plan at any time. The most common qualifier is getting married, although it usually only qualifies if one spouse already had insurance before the marriage. If someone has insurance but moves to a new area where new health plans are available, he or she can switch to a new plan if desired. Someone who involuntarily lost other health coverage may be able to enroll outside of the open enrollment window as well. Other qualifying events include becoming a citizen of the United States, becoming a dependent of someone else, giving birth to a child, or adopting a child.

What Should Someone Consider When Choosing a Health Insurance Plan?

Even if you like your current plan, it’s always a good idea to review the available options during the open enrollment, just in case another option better fits the needs of you and your family. Even if nothing has changed within your family, new insurers or lower premiums can determine whether you make a switch.

It’s also important to compare your estimated annual costs rather than focusing solely on monthly premiums. The cost of the monthly premium may seem like the most important factor, but if you have a high deductible or co-payments that are much more expensive than you are used to, the low premium may not be worth it. Compare the prices with how much you’ll truly use your healthcare as well. Paying a bit more monthly is worth it if you know you spend a lot of time at the doctor, for example, since you’ll likely have lower co-pays. On the other hand, those who are young, healthy, and don’t spend a lot of time in doctor’s offices can usually “risk it” with the lower premium.

Start Your Research Today

The best time to start thinking about your health insurance choices is now. By considering your needs and beginning to make comparisons now, you’ll be better equipped when open enrollment rolls around. Researching now prevents you from rushing into a decision when the time does come and ensures you get the coverage that you need at a price point you can afford. Start your search with a reputable company by comparing insurance options for policies in your price range. Our experts are always ready to help you understand your options and make the best choice.