The ACA can either be run at the federal level on Healthcare.gov or states can elect to run their own platforms such as Covered California and Mass Health Connector. These are known as state based marketplaces (SBMs). SBMs have tremendous flexibility in that the state takes on the responsibility for the overwhelming majority of the day to day administration of the ACA and they gain an incredible amount of flexibility including the ability to offer Special Enrollment Periods (SEP) at their discretion. California and Maryland had pre-COVID19 SEPs going due to new state regulations offering either enhanced subsidies or a state based individual mandate.
SBMs have been in front of the curve on getting SEPs for COVID19. Charles Gaba has been tracking this aggressively:
CA, CO, CT, DC, MD, MA, NV, NY, RI & WA residents can still #GetCovered via Special Enrollment Periods!
These SEPs are in addition to “lose your job/health insurance SEPs” that are available to everyone.
If you are currently uninsured, there is likely very low cost plans available to you. The Kaiser Family Foundation estimates that a quarter of the currently uninsured qualify for a zero or $1 premium bronze plan. A fellow insurance nerd has detailed estimates for minimum premium availability in Florida that tracks with most of the nation:
There are 1.12m uninsured Floridians who should be able to get coverage for 0-2% of their income. I don't know why they didn't get coverage during OEP, but a wide-open ASAP SEP would allow them to reconsider that decision given what's happening. pic.twitter.com/fRYVmzVSyA
— Gabriel McGlamery (@jgmcglamery) March 19, 2020
These are high deductible plans. The cheapest plan in most counties will usually have a deductible over $7,000. That is a lot. However, the choice is a zero premium, capped deductible plan with some pre-deductible services including COVID19 testing in a pandemic or a zero premium, infinite deductible plan.
If you are currently uninsured and are in one the SBM states, look for a zero premium plan at the very least during this special enrollment period.
How are income and subsidy calculated if you’ve been laid off?
This is off-topic, but you are the insurance guru …
My husband and I currently have insurance w/BCBS through the marketplace. But my husband is unemployed b/c of health issues and my work as a contract writer has utterly dried up, so income has vanished.
I’m getting emails ‘n’ such from many of our providers – car loan, mortgage, etc. – with offers to defer payments due (though of course the interest will continue to pile up). But not a peep about health insurance, and it’s one of the biggest bills I pay each month.
Any indication that the health insurance companies will take some steps to help their customers?
@WV Blondie: Good question!
If you bought on the Exchange:
#1 Go back to Healthcare.gov and update your income for your subsidy to be recalculated.
#2 Call your insurer and see if they will work with you.
#3 if #1 and #2 don’t work, apply for Medicaid as Medicaid eligibility is determined by monthly income and not annual income.
@David Anderson: Thanks! Truly helpful guidance – you’re a peach.
@Butch: Subsidies are based on your best estimate of your income for the entire year with reconciliation during next tax filing season.
If you are on an Exchange plan, go to either Healthcare.gov or your state marketplace to update your income with your best estimate of what you’ll make for the rest of the year. The exchange will adjust your subsidy level.
@David Anderson: Thanks, David. Businesses for both spouse and me have been pretty much shut down by the outbreak, so a little reduction certainly would be welcome!