A new benefit has appeared on the horizon for Louisianians. It will allow many of us to have a never-ending Open Enrollment Period on Healthcare.gov, the marketplace for individual health insurance.
Yep, I said never.
A New Never-Ending Story
New federal guidance says that, soon, any person or household with an income up to 150% of the federal poverty level can enroll in health care on healthcare.gov at any time. That means they can purchase individual health insurance without waiting until the usual Open Enrollment Period that happens in November or December each year.
What’s 150% of the federal poverty level? Well, in terms of household size and annual income, it looks like this:
HH Size | 150% of FPL Annual | 150% of FPL Monthly | Hourly (@35hrs/week) |
1 | $20,385 | $1,698 | $11.20 |
2 | $27,465 | $2,288 | $15.09 |
3 | $34,545 | $2,878 | $18.98 |
4 | $41,625 | $3,468 | $22.87 |
5 | $48,705 | $4,058 | $26.76 |
6 | $55,785 | $4,648 | $30.65 |
7 | $62,865 | $5,238 | $34.54 |
8 | $69,945 | $5,828 | $38.43 |
We expect this new benefit to be fully online by April 1, 2022. Then, anyone whose household income is at or below the incomes listed above will have an automatic Open Enrollment Period on www.healthcare.gov – whenever they need it.
But Mike, what about Medicaid?
It’s important to point out that here, in Louisiana, our Medicaid program already covers everyone up to 138% of the federal poverty level. But there are millions of Americans who live in states with much less generous Medicaid programs. This change to Healthcare.gov will provide, perhaps for the first time, an opportunity for them to enroll in federally subsidized health insurance coverage all year round.
Think about the Southeastern Conference states: only Louisiana, Arkansas and Kentucky have expanded Medicaid. Alabama hasn’t. Florida hasn’t. Georgia hasn’t. And our next-door-neighbor, Texas, hasn’t either. This new rule will have a big impact in those states.
In Louisiana, if people lose Medicaid eligibility for pretty much any reason, but their income remains low, they can access open enrollment on Healthcare.gov all year ‘round. This is critical to keeping them covered.
And to make it more interesting, if a person’s income is at or below 150% of federal poverty level, there are FREE health insurance plans ($0 premium) available for nearly every age, in every corner of the state. This will help folks who have to transition off of Medicaid gain coverage to keep them healthy.
Straight Talk is, more opportunities to get covered with health insurance are right around the corner for many of us. And if you want to access the health care system here in Louisiana, it’s a huge help if you have a third-party payer (like Medicaid, Medicare or Blue Cross) in your corner. Don’t hesitate to take advantage of this opportunity and sign up so you stay covered.
Good afternoon Mike! What will this do to the already sky high premiums for individual coverage? Now anyone can just wait until they need an expensive medical procedure and apply for coverage. Your thoughts?
Pierre! Sorry I’m behind answering questions.
Yes, the fastest way to increase insurance costs in healthcare is to discourage the healthiest among us from joining the pool. Anything that allows people to wait until AFTER they get sick to enroll drives up costs for everyone else. There is no magic financing in healthcare!
thanks..mrb
Can they only be enrolled through healthcare.gov? Or can we do and off exchange policy also?
Mike, I have looked on healthcare.gov, but I do not see anything about the year round open enrollment. Will there be anything on their site? You mentioned that starting April 1st, so that means a person cannot have the coverage to start until May 1st, correct? Thanks,
Sharon!
Thanks for your question. The “year round open enrollment” is already in effect for anyone making less than 150% of the federal poverty level. You may need to call them to get the open enrollment, but it’s already in place.
thanks..mrb