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As of November 1, many Affordable Care Act (ACA) marketplaces have opened enrollment for 2023 health insurance coverage.
The ACA Health Insurance Marketplace offers health insurance to people living in the United States who don't have access to or do not wish to use an employer-sponsored plan.
While most plans give you until mid-December to sign up, experts say now is the time to explore your options.
"People shouldn’t wait until the last minute to review their options and sign up," Karen Pollitz, a senior fellow at the Kaiser Family Foundation, a healthcare research nonprofit, told Verywell. "Rates change, as do insurers and insurance offerings, and you need time to figure out what’s best and what’s affordable."
Here's what new for the ACA Health Insurance Marketplace in 2023.
Middle- and low-income consumers who don’t have access to affordable employer-sponsored health insurance or federal coverage like Medicare and Medicaid may be eligible for discounts via the ACA marketplace. Specifically, if premiums for the ACA benchmark plan cost more than a certain percentage of their income (anywhere between 0 and 8.5%, depending on income level), they may qualify for premium subsidies—tax credits typically paid directly to health insurance providers each month.
The recently-enacted Inflation Reduction Act is extending COVID-related premium subsidy increases through 2025. That means people with higher incomes may find they have to pay less in monthly premiums than they did before the pandemic because of the increased subsidies. There is no longer an income cutoff at 400% of the federal poverty level.
If you don’t qualify for these subsidies, premiums are rising an average of 3.8% across the different marketplaces. Working with a navigator can help make sure you input all your pertinent information to maximize your chance of getting a subsidy.
Until this year, an estimated 5.1 million people were ineligible for marketplace subsidies because of what is known as the "Family glitch."
Generally, people are ineligible for marketplace subsidies if they have an offer of “affordable” job-based health insurance coverage—including through a family member’s job, Pollitz said.
However, until now, the affordability of job-based coverage for a worker’s spouse and dependents was based only on the premium cost of the individual employee. So, if an employer insurance offer met the affordability threshold for self-only coverage but not for family coverage, those family members were nonetheless considered to have an offer of “affordable” job-based health coverage, and could not get coverage through the marketplaces.
New rules for 2023 use the cost of a family’s premiums, not the individual's. If that is more than 9.12% of household income in 2023, family members will have the option of buying health coverage through the ACA marketplace and will be eligible for premium tax credits based on their income.
In recent years, insurance companies offering policies on HealthCare.gov could refuse to renew coverage for people who had fallen behind on premium payments the year before. But according to Pollitz, for 2023, people who fell behind on premium payments in 2022 (or even lost coverage because they didn’t pay) will still be able to enroll in a 2023 policy offered by that insurer.
While the January 2023 payment can’t be applied to past due amounts, the insurer is within their rights to ask for past due amounts after that. But they can’t deny your 2023 coverage.
While people who have a “life qualifying event” such as a divorce or marriage have always been able to sign up for marketplace coverage even after the open enrollment period ends, they needed to show documentation of the event, which kept some people from applying.
For 2023 coverage, Pollitz said only people who lose other coverage will have to show documentation. Others will just be able to note the qualifying event online and sign up.
Starting November 1, you can log into (or create) and Affordable Care Act Marketplace account, fill out an application, and enroll in a 2023 marketplace health insurance plan. Enroll by December 15, 2022, for coverage that starts January 1, 2023.
January 15, 2023, is the last day to enroll in or change a 2023 health plan—unless you have a major change.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
By Fran Kritz
Kritz is a healthcare reporter with a focus on health policy. She is a former staff writer for Forbes Magazine and U.S. News and World Report.
