The Department of Health and Human Services (HHS) released its final national snapshot for the 2022 open enrollment period on January 27, 2022, announcing that 14.5 million people have enrolled in marketplace coverage through January 15, 2022. According to previous snapshots, marketplace enrollment is at an all-time high, and the number of new consumers enrolling in coverage is much higher than in previous years.
10.3 million people enrolled through HealthCare.gov, and about 4.2 million people enrolled through 18 state-based markets, out of a total of 14.5 million people. While HealthCare.gov and many state-based markets had an enrollment deadline of January 15, five state-based marketplaces (in California, Kentucky, New Jersey, New York, and Rhode Island) will extend open enrollment until January 31.
This indicates that total enrollment for the open enrollment season in 2022 will continue to rise. Up until January 15, an additional 954,000 people signed up for New York’s Basic Health Program; enrollment statistics for Minnesota’s Basic Health Program were unavailable.
This is a dramatic shift in market enrollment patterns. Enrollment for 2022 is around 2.5 million individuals greater than last year, and about 1.8 million higher than the previous enrollment high of the 2016 plan year (when enrollment reached 12.7 million people). Enrollment fell each year after peaking in 2016, until the 2021 plan year, when it climbed for the first time under the Trump administration. This is where you can keep track of your annual enrollment.
Since 2021, 5.8 million people have acquired new coverage, according to the Biden administration. During the six-month COVID-19 particular enrollment period, 2.8 million individuals enrolled, and 3 million people joined during the 2022 open enrollment period.
Let’s take a step back and look at health insurance and the importance of the enrollment period.
What is health insurance?
A contract requiring an insurer to pay some or all of a person’s healthcare bills in exchange for a premium is known as health insurance. More specifically, health insurance often covers for the insured’s medical, surgical, prescription drug, and occasionally dental expenses. Health insurance can pay the care provider directly or compensate the insured for expenses incurred as a result of illness or accident.
It’s frequently included in employee benefit packages as a way to entice top talent, with premiums partially covered by the business but frequently withheld from employee paychecks. With limited exclusions for S company employees, the cost of health insurance premiums is deductible to the payer, and the benefits received are tax-free.
How does health insurance work?
It might be difficult to understand health insurance. For the maximum level of coverage, managed care insurance plans require policyholders to receive care from a network of certified healthcare providers. Patients must pay a higher percentage of the cost if they seek care outside the network. In some situations, the insurance company may refuse to pay for out-of-network services altogether.
Many managed care plans, such as health maintenance organizations (HMOs) and point-of-service plans (POS), require patients to select a primary care physician to oversee their care, provide treatment recommendations, and refer them to medical specialists. In contrast, preferred-provider organizations (PPOs) do not require referrals but have lower rates of in-network practitioners and services.
Certain services provided without prior authorization may also be denied coverage by insurance carriers. In addition, if a generic version or comparable prescription is available at a cheaper cost, insurers may refuse to pay for name-brand pharmaceuticals. All of these restrictions should be specified in the insurance company’s materials and should be thoroughly reviewed. Before making a large purchase, check with your employer or the company directly.
Copays, which are set fees that plan subscribers must pay for services such as doctor visits and prescription drugs; deductibles, which must be met before the health insurance will cover or pay for a claim; and coinsurance, which is a percentage of healthcare costs that the insured must pay even after they’ve met their deductible, are all becoming more common in health insurance plans (and before they reach their out-of-pocket maximum for a given period).
Monthly rates for insurance plans with larger out-of-pocket expenditures are often lower than for policies with low deductibles. Individuals must consider the benefits of decreased monthly payments against the danger of big out-of-pocket expenses in the event of a serious illness or accident when looking for policies.
TIP
If you’re self-employed, you may be able to deduct up to 100% of the health insurance premiums you pay out of pocket.
High-deductible health plans (HDHP)
A high-deductible health plan is one type of health insurance that is becoming increasingly popular (HDHP). Higher deductibles and lower rates characterize these insurance plans. A high-deductible health plan, according to the IRS, is one with deductibles of at least $1,400 for an individual or $2,800 for a family in 2021. Individual maximum out-of-pocket expenses are $7,000, while a family’s maximum out-of-pocket expenses are $14,000.
The deductible limitations will not change in 2022. The out-of-pocket maximums, on the other hand, will rise to $7,050 and $14,100, respectively. Out-of-network services are not subject to out-of-pocket maximums.
High-deductible health plans have a distinct advantage in that they allow you to form a health savings account and pre tax d eposit income to it, which may be used to pay for qualified medical expenses. These schemes provide a three-fold tax benefit:
- Contributions are deductible for tax purposes.
- Contributions are tax-deferred and grow over time.
- Withdrawals for qualified medical costs are tax-free.
In addition to health insurance, qualified sick persons can benefit from a variety of auxiliary goods on the market. Disability insurance, critical illness (catastrophic) insurance and long-term care (LTC) insurance are examples.
After age 65, you can withdraw money from an HSA without penalty for any purpose, however, you will owe income tax if the money is not used for eligible medical expenditures.
Special Considerations
The Affordable Care Act (ACA) was signed into law by President Barack Obama in 2010. Medicaid, a government program that provides medical treatment to those with very low incomes, was expanded in participating states under the legislation. The ACA also established the federal Health Insurance Marketplace in addition to these measures. It also made it illegal for insurance companies to refuse coverage to patients with previous diseases, and it enabled children to stay on their parent’s insurance until they turned 26.
Individuals and businesses can use the Marketplace to find quality insurance plans at reasonable prices. The legislation requires that insurance purchased through the ACA Marketplace cover ten essential health benefits. Shoppers can find their state’s Marketplace on the HealthCare.gov website.
A premium tax credit may be available to eligible insureds to help defray the cost of health insurance purchased through the federal marketplace.
Changes in the Affordable Care Act
Americans were obliged to have medical insurance that met federally defined minimum requirements under the Affordable Care Act (ACA), but Congress repealed that requirement in December 2017. In 2012, the Supreme Court threw down an ACA provision that obliged states to expand Medicaid eligibility as a condition of receiving federal Medicaid funding, and a number of states elected to decline. By 2021, the Affordable Care Act will have covered an estimated 31 million people.
Medicare and CHIP
Medicare and the Children’s Health Insurance Program (CHIP) are two governmental health insurance programs that serve elderly people and children who require health insurance. People with disabilities can also benefit from Medicare, which is available to anyone aged 65 and up. The CHIP plan covers babies and children up to the age of 18 and has income limits.
Medicare does not cover the cost of long-term care in a nursing home, although Medicaid does.
What is health insurance, and why do you need it?
In exchange for a premium, you enter into an arrangement with an insurer to have them pay for some or all of your medical bills. Medical expenditures that you can’t afford to pay out of pocket can be avoided with health insurance.
Who needs health insurance?
Everyone has an easy answer. Minor or serious medical difficulties, such as operations or treatment for life-threatening illnesses, can be covered by health insurance. However, under the terms of the Affordable Care Act, you will not be punished if you do not have health insurance.
How do you get health insurance?
You may be insured if your employer provides health insurance as part of an employee benefits package. Health insurance can also be purchased through the Health Insurance Marketplace. Certain people may be eligible for health insurance through Medicaid or Medicare programs.
How much does health insurance cost?
The scope of coverage, the type of plan you have, and your deductibles can all affect your health insurance expenses. Copays and coinsurance can add to the cost, so think about how much you’ll pay before signing up for a healthcare plan.
What is the annual open enrollment period?
The annual time during which you can enroll in major medical health insurance plans or ACA-compliant health insurance plans is known as open enrollment. Check out our list of open enrollment dates in every state to learn when they will be held in your area.
Why do we have an open enrollment period?
The open enrollment period was established to prevent adverse selection, which occurs when sick people enroll in health insurance, and healthy ones do not. It significantly distorts the amount of financial risk that a health plan assumes while insuring customers.
It also helps people avoid the risk of going without health insurance if they need expensive, unexpected medical care or have a chronic illness. Individuals cannot be denied ACA-compliant health insurance because of their health status during an open enrollment period.
When is the annual open enrollment period?
The federal open enrollment period for health insurance coverage beginning in 2022 runs from November 1, 2021, through January 15, 2022. You must join up before December 15, 2021, to receive coverage beginning January 1, 2022. Also, make sure to check the dates of your state’s open enrollment period.
Instead of using the federally operated marketplace, some states have state-administered health insurance markets. These states have the authority to prolong open enrollment for an additional period of time. A number of states have recently announced prolonged open enrollment periods to handle issues that have arisen as a result of the COVID-19 outbreak. If you reside in a state with a state-run marketplace, keeping up with health insurance news is important.
California, Colorado, Connecticut, Idaho, Massachusetts, Maryland, Minnesota, Nevada, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, and Washington are the 14 states that now operate state-based exchanges.
While the federal open enrollment period runs from November 1 to January 15, a few states have announced prolonged open enrollment periods that will go indefinitely. California, Colorado, and Washington, DC have all declared that their open enrollment periods will be extended indefinitely.
When does the open enrollment period end?
The open enrollment period ends on January 15th, unless you’re living in a state with an extended open enrollment period.
- The open enrollment period in California will end on January 31, 2022. December 15, 2021, is the last day to apply for coverage beginning January 1, 2022.
- After December 15, 2021, insurance will begin no later than February 15, 2022.
- The open enrollment period in Colorado will end on January 15, 2022. December 15, 2021, is the last day to apply for coverage beginning January 1, 2022. After December 15, 2021, insurance will start no later than February 15, 2022.
- The open enrollment period in Washington, DC, will end on January 31, 2022.
- The state-run marketplace in Pennsylvania is open for enrollment through January 15, 2022.
- The open enrollment period in New Jersey runs until January 31, 2022.
Connecticut, Idaho, Maryland, Nevada, Rhode Island, and Washington are among the states with state-run markets that have extended open enrollment in the past but have not done so in the future.
Marketplace enrollment record
In comparison to the open enrollment period in 2021, the enrollment of 3 million new consumers is up considerably (when 1.8 million new consumers enrolled in coverage for 2021). In 2022, new enrollees accounted for nearly 21% of overall enrollment (consistent with last year). Since many new consumers enrolled earlier in 2021, the proportion of new participants has remained low. If they haven’t found another source of coverage, those customers have most certainly renewed or been auto-enrolled in 2022 coverage (putting them in the “returning” customer group).
The latest national snapshot contains state-specific data from January 15 to reflect marketplace enrollment. Enrollment continues to be notably strong in states that have not expanded their Medicaid program, as it has been in previous snapshots.
California (1.8 million individuals), Florida (2.7 million people), Georgia (701,000 people), North Carolina (670,000 people), and Texas are the states with the largest enrollment thus far (1.8 million people).
Increased marketplace subsidies under the American Rescue Plan Act, as well as investments in marketing, outreach, and the navigator program, are credited by HHS for the increased enrollment. For the first time, the American Rescue Plan Act extended subsidies to many middle-income people and raised payments for those with lower incomes. Consumers who used HealthCare.gov saw their average monthly rates drop by 23%, and 32% of them chose a plan that cost $10 or less per month.
HHS also says that over 1,800 outreach and education events were held by 1,500 certified navigators to help educate communities and connect individuals with coverage options.
ASPE report on changes in uninsurance
On the same day, the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a new report analyzing survey data from the National Health Interview Survey (NHIS) to assess changes in the uninsured rate since the American Rescue Plan Act was enacted. According to the latest available NHIS data, the uninsured rate was 8.9% in the third quarter of 2021. (down from 10.3 percent for the last quarter of 2020).
ASPE credits a variety of factors for the drop in the uninsured rate, including increased marketplace subsidies under the American Rescue Plan Act, the COVID-19 special enrollment period, outreach and education, and Medicaid expansion.
Those with earnings below 200 percent of the federal poverty threshold had the greatest gains in coverage. ASPE also points out certain flaws in the NHIS data, suggesting that coverage rates for the fourth quarter of 2021 (rather than the third) and the entire year of 2021 might be more conclusive.
New investments in outreach and enrollment for Medicaid and CHIP
HHS also announced $49.4 million in support for organizations that will assist connect more children and their parents to Medicaid and CHIP coverage on January 27. Officials at the federal level aim to reach out to the 2.3 million uninsured children who are eligible for Medicaid and CHIP but are not registered. This is especially crucial to promote health equity because American Indian and Alaska Native children (11.8 percent), Hispanic children (11.4 percent), and non-Hispanic Black children have disproportionately high uninsured rates (5.9 percent).
Selected partners will use the funds to engage schools, work in underserved communities, provide enrollment and renewal services, undertake education and outreach activities, and more. Each organization chosen would receive up to $1.5 million over three years to assist reduce the number of uninsured children and pregnant women by increasing Medicaid/CHIP enrollment and retention.
How long is the open enrollment period?
The open enrollment period in the federal government lasts 45 days. When it comes to states that have their own permanent prolonged open enrollment period, the open enrollment period varies in length.
When is the open enrollment period for health insurance for the 2022 coverage year?
The federal open enrollment period for acquiring health insurance coverage beginning on January 1st, 2022 runs from November 15, 2021, through December 15, 2021. Coverage will begin on February 1, 2022, rather than January 1, 2022, for enrollments completed between December 16, 2021, and January 15, 2022.
What are the exceptions to open enrollment?
You must enroll for health insurance during the open enrollment period unless you have a qualifying life event. Loss of coverage through an employer, loss of coverage through a covered employee, and substantial family changes are all examples of qualifying life events that will qualify you for a special enrollment period.
Conclusion
The federal open enrollment period for health insurance coverage beginning in 2022 runs from November 1, 2021, through January 15, 2022. You must join up before December 15, 2021, to receive coverage beginning January 1, 2022. Also, make sure to check the dates of your state’s open enrollment period.
