Minneapolis, MN – The open enrollment period for Affordable Care Act (ACA) health plans is set to begin on Nov. 1, with several updates that could enhance enrollment numbers. Healthinsurance.org outlines the upcoming changes, including expanded eligibility for DACA recipients, state-specific adjustments, and new limits on the duration of short-term health insurance plans.
For most states, the open enrollment period for 2025 Marketplace coverage runs from Nov. 1, 2024, to Jan. 15, 2025.
“Open enrollment is approaching quickly, and there are important changes that people should be aware of,” stated Louise Norris, a health policy analyst at healthinsurance.org.
DACA recipients are now eligible for Marketplace coverage and subsidies
Thanks to a recent rule change by the Biden administration, approximately 100,000 DACA recipients—individuals within the Deferred Action for Childhood Arrivals program—will now qualify for ACA Marketplace plans and federal premium subsidies, starting Nov. 1. This new regulation also makes DACA recipients eligible for Basic Health Program (BHP) coverage, although two of the three states currently with BHPs allow DACA recipients to enroll already.
Nonetheless, 19 attorneys general are pursuing efforts to delay and reverse the DACA eligibility adjustment. Oral arguments are anticipated for mid-October, and a decision could be announced shortly before the open enrollment period begins, creating some uncertainty regarding DACA recipients’ eligibility for 2025 Marketplace coverage.
Short-term health insurance plans to have new duration limits
A new federal regulation imposes limits on the duration of all short-term health insurance plans—effective from Sept. 1, 2024, onwards—to a maximum of four months, including renewals. This is a significant reduction from the previous allowance of up to 36 months across most states.
This means consumers might purchase a short-term plan on or after Sept. 1 and possibly extend it through to the year’s end. However, open enrollment is the first chance for many of these consumers to secure replacement coverage through the Marketplace for 2025.
“The new federal regulation prevents consumers from relying on short-term health insurance policies for extended periods,” explained Norris. “Failing to participate in open enrollment this fall could result in limited or no full-year coverage options for 2025.”
Some states provide their own subsidies
Last year, 93 percent of Marketplace participants received federal premium tax credits, which help reduce coverage costs. Enhanced federal premium subsidies from the American Rescue Plan (ARP) will remain available for 2025 due to the Inflation Reduction Act (IRA).
Nine states also offer state-funded subsidies, which will see increases in California and New Mexico for 2025. Additionally, New York will introduce a new subsidy program for 2025 coverage.
Conversely, Colorado is scaling back its subsidy program. Starting in 2025, the eligibility threshold for Colorado state subsidies will revert to 200% of the federal poverty level (FPL), down from 250% in 2024.
Insurers changing their market presence for 2025
Several insurance carriers are entering state Marketplaces for 2025 coverage. Notably, WellPoint will now provide services in Texas, Florida, and Maryland. Other expanding insurers include Simply Healthcare Plans in Florida, UnitedHealthcare in Indiana, HAP CareSource in Michigan, and WellSense in New Hampshire.
On the other hand, states experiencing insurance carrier exits from Marketplaces include Indiana, Kansas, New Mexico, Pennsylvania, South Carolina, Tennessee, Texas, Utah, and Washington.
New consumer protections may influence the enrollment process
In July, the federal government updated its guidelines to safeguard consumers from unauthorized alterations to their health coverage. The new policy mandates that consumers confirm brokers’ authorization to assist with their enrollments on HealthCare.gov or through an approved enhanced direct enrollment platform. The required steps may differ based on the broker. States handling their own exchanges will implement their specific protocols to ensure that enrollments and plan modifications occur with enrollee consent.
“This new requirement aims to safeguard consumers against fraudulent enrollments or unintended plan changes,” Norris notes. “However, it means consumers must plan in advance to ensure they have enough time to receive enrollment assistance from a broker.”
Healthinsurance.org offers online resources to help consumers understand individual and family health insurance options. Owned by HealthInsurance.org, LLC, the site has been a provider of health insurance information and health reform education for over 25 years.
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