Enrollment in Individual Health Plan is still possible after Ending of COVID SEP in the Most States

Health Plan after COVID

The COVD related Special Enrollment Period may have ended on August 15, 2021, in most states but the American Rescue Plan’s health insurance affordability provisions are still in effect and available for many individual market buyers. It means individuals who have an opportunity to buy coverage again either through open enrollment or due to qualifying life events are likely to find affordable individual health insurance that they might have received before the ARP.

ARP Premium Subsidies

Premium subsidies offered under the American Rescue Plan are available since April 2021, and more than 2 million people have enrolled in health plans through the exchange during the COVID-related Special Enrollment Period to avail of the additional subsidies. However, a major provision of the law took effect on July 1, when additional subsidies were made available to people who have received unemployment compensation this year. The 36 states that use Healthcare.gov and some of the state-based exchanges have made unemployment-based additional subsidies available from July 1, 2021.

The American Rescue Plan is Still Effective and Making Premiums Affordable

The American Rescue Plan is the most vital improvement in health insurance affordability after the implementation of the Affordable Care Act. ARP has increased the premium subsidies in the health insurance exchange and also eliminated the subsidy cliff. The American rescue Plan included numerous provisions to make ACA-compliant plans more affordable but the ARP is now delivering additional health insurance subsidies that include:

  • Individuals who were already subsidy-eligible are entitled to larger subsidies.
  • The subsidy cliff has been eliminated thereby making more individuals eligible for subsidies.
  • Individuals who have received any unemployment compensation this year enjoy free coverage with full cost-sharing reductions.
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All the ARP benefits continue to be available and the additional unemployment-based subsidy will be continued through the end of 2021, while the other ARP subsidy enhancements will be available through the end of 2022. There is also a possibility of the ARB subsidy o be available for a longer period if Congress extends them.

ARP Subsidies Gained Immense Popularity

U.S. Department of Health and Human Services has reported that more than 2.5 million people have enrolled in health coverage during the COVID-related Special Enrollment Period and 2.6 million existing marketplace enrollees had activated their ARP subsidies. The average after-subsidy premiums for the new enrollees of the marketplace plan were $85 per month as compared to $117 per month before the ARP’s subsidies became available. Moreover, 35% of the new and renewing enrollees had obtained coverage with after subsidy premiums of less than $10 per month. Special Enrollment Period report also shows that ARP has lowered health care costs for Americans.

Data also shows that individuals and families are on average saving $40 per person in a month because of the ARP’s premium credits. The American rescue Plan has also lowered the out-of-pocket costs for new enrollees of the health plan since April 1, 2021. The median plan deductible has fallen by nearly 90%, from $450 to $50. The ARP’s expanded premium tax credits have reduced insurance premiums, increased savings, and provided people access to quality and affordable health care coverage through the Marketplace. The rise in health insurance enrollment indicates the success of the ARP that works to build upon the Affordable Care Act and deliver high-quality and affordable health care for millions of Americans. Thus in states where the Special Enrollment Period is still open, or if individuals qualify for Special Enrollment Period in any state, then they should check the affordable health plan options available to them.

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States where Special Enrollment Period Continues

In the states that use HealthCare.org, the COVID-related SEP ended on August 15, 2021, but in the states that run their own exchanges, the Special Enrollment Period is still ongoing. The states where the SEP continues are:

California – SEP continues through December 31, 2021, for uninsured residents and individuals switching from off-exchange to on-exchange coverage.
Connecticut – Enrollment in this state continues till October 31.
District of Columbia – Enrollment continues through the end of the pandemic emergency period.
Minnesota – Though the COVID-related special enrollment period has ended in the state in mid-July but the state’s marketplace is allowing people to enroll or switch to a $0 premium plan if they have received unemployment compensation this year.
New Jersey – Enrollment in the health insurance plans continues through December 31, 2021.
New York – residents can enroll in health plans till December 31, 2021.
Vermont – The uninsured residents of the state can enroll in health plans through October 1, 2021.

Enrollment Options for Individuals Having a Qualifying Life Event

Individuals who are not residing in any of those seven states can still have a Special Enrollment Period if they experience a qualifying life event. The most common reason for a personal SEP is a loss of employer-based health coverage. Usually, there is only a 60-day window to enroll in a new plan after losing other coverage but HealthCare.gov is making an exception for people who lost their coverage a long ago as January 2020, if they missed their enrollment deadline because of COVID-19 emergency. People have the chance to utilize this flexibility by directly calling the marketplace to qualify for a special enrollment period on a case-by-case basis. Besides the loss of employer-based coverage, some other situations when individuals will qualify for SEP are adoption or birth of a child, marriage (if one spouse already had minimum essential coverage), or an individual’s grandmothered or grandfathered plan coming up for renewal.

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Other Options to Enroll in ACA-compliant Coverage

Besides the ongoing COVID-related enrollment periods and the Special Enrollment Period triggered by qualifying life events, there are some other circumstances in which individuals may be eligible to enroll in affordable health coverage.

  • The Open Enrollment continues all through the year in a state for individuals who are eligible for Medicaid or CHIP
  • Residents of New York and Minnesota who are eligible for the Basic Health Programs can enroll anytime in a health plan.
  • Connecticut’s residents who are eligible for the family program can enroll till the end of 2021 to sign up for free coverage.
  • Residents of Massachusetts who are newly eligible for the ConnectorCare program can anytime enroll in the program.
  • Native Americans all through the year can enroll in marketplace plans.

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