Minnesota, New York, and Oregon have implemented a Basic Health Program – a coverage for people ineligible for Medicaid and with incomes up to 200% of FPL (250% in New York), and for legal immigrants who aren't eligible for Medicaid because of the five-year waiting period.| healthinsurance.org
A proposed federal rule issued this week would, if finalized, bring wide-ranging changes for the Affordable Care Act’s health insurance Marketplace, including a shorter open enrollment period in all states.| healthinsurance.org
The federal poverty level (FPL) - also referred to as the federal poverty guidelines – is used to determine eligibility for Medicaid and CHIP, and for premium subsidies and cost-sharing reductions in the health insurance marketplace.| healthinsurance.org
The U.S. Department of Health and Human Services has finalized a special enrollment period in states that use HealthCare.gov, granting year-round enrollment in ACA-compliant health insurance if an applicant’s household income does not exceed 150% of the federal poverty level and if the applicant is eligible for a premium tax credit.| healthinsurance.org
If your employer-sponsored insurance becomes unaffordable or stops providing minimum value, the change may make you eligible for a special enrollment period.| healthinsurance.org
As of the 2025 plan year, there will be 20 fully state-run health insurance marketplaces (SBMs), three state-based marketplaces that use the federal platform (SBM-FP), and 28 fully federally run marketplaces. Three of the SBMs had an SBM-FP model in 2021, but transitioned to their own enrollment platforms as of the 2022 plan year. Virginia joined them in the fall of 2023, and Georgia will also be running its own exchange platform by the fall of 2024. Illinois has enacted legislation to creat...| healthinsurance.org
An off-exchange plan is a health insurance policy that is purchased directly from an insurance company or through an agent or broker, outside of the official ACA-created health insurance exchange.| healthinsurance.org
A cost-sharing reduction (CSR) is a provision of the Affordable Care Act that reduces out-of-pocket costs for eligible enrollees who select Silver health insurance plans in the marketplace. CSRs – often referred to as cost-sharing subsidies – reduce enrollees' cost-sharing by lowering a health plan's out-of-pocket maximum, and increasing the actuarial value (AV) of the plan.| healthinsurance.org
Immigrants can enroll in ACA-compliant individual health insurance just like any other lawfully present U.S. resident. Lawfully present immigrants are eligible for premium subsidies.| healthinsurance.org
According to Kaiser Family Foundation data, there are about 1.9 million people in the coverage gap across nine states (this does not include North Carolina, as Medicaid expansion will take effect there in late 2023). They aren't eligible for Medicaid, nor are they eligible for premium subsidies in the exchange.| healthinsurance.org
Need more info about Medicaid in your state? Get updated information on the current status of Medicaid expansion, along with general information about each state’s program.| healthinsurance.org
