What you should know about the 2023 health insurance marketplace open registration

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For individuals or families who purchase or may purchase health insurance through the public market, the opportunity to opt for 2023 coverage is drawing near.

Open registration, where you can select a health plan for the next year, runs November 1 through January 15 for the federal market at HealthCare.gov and most state exchanges. Generally, individuals who are insured in this manner are self-employed or unable to obtain workplace insurance, or are not eligible for Medicaid or Medicare.

Nearly 13 million of the 14.5 million people enrolled in private health insurance through the public marketplace — authorized by the Affordable Care Act of 2010 — receive subsidies (technically tax credits) that lower their premium payments. Some individuals may also qualify for cost-sharing assistance such as deductibles and co-payments on certain plans, depending on income.

Here’s what you need to know for 2023.

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Premiums increase by an average of 4% to 5%

Note that premiums will rise an average of 4% to 5% nationwide over the next year, said Cynthia Cox, director of the Kaiser Family Foundation’s Affordable Care Act program.

However, she said, there are many differences between states. In Virginia, for example, premiums are down an average of 18% and in New Mexico they’re up 14%, Cox said.

“Most fall between 1% and 7% increases,” she said.

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If you have market coverage and are faced with a large premium increase, you can always check to see if a cheaper option is available, Cox said.

Even more generous subsidies apply

However, more generous financial aid remains in place.

That is, temporarily extended subsidies introduced for 2021 and 2022 were extended to 2025 in the anti-inflation law that went into effect in August.

This means there is no income cap to qualify for subsidies and the amount anyone pays for rewards is capped at 8.5% of their income as calculated by the exchange. Prior to the changes, assistance was generally only available to households with incomes between 100% and 400% of the federal poverty line.

The Marketplace Subsidies you are eligible for are based on factors such as income, age, and the second cheapest “Silver” plan in your geographic area (which may or may not be the plan you sign up for).

Make sure you give a good estimate of 2023 income

Since the amount of your subsidy will depend, at least in part, on your income, you will need to estimate it in the 2023 application process.

A good estimate is important. If your annual income is higher than what you declared when registering, this may mean that you will not receive as much benefit as you receive. And any overage would need to be accounted for at tax time in 2024 – which would reduce your refund or increase the amount of tax you owe.

“You don’t want a nasty surprise when you pay your taxes next year,” Cox said.

If you are entitled to more than you received, the difference would either increase your refund or reduce the amount of tax you owe.

Either way, at any time during the year you can adjust your income estimate or note relevant life changes (birth of a child, marriage, etc.) that could affect the amount of benefit you are entitled to.

The “Family Bug” will generally be fixed by 2023

Workers who do not receive employer-sponsored health insurance that is considered “affordable” — no more than 9.61% of earnings that year — will be allowed to enroll in a plan through the marketplace. However, the measure of affordability is based on the cost of employee-only insurance.

This is true even if a worker wants dependents to be covered as well – meaning the actual cost of family insurance could well exceed that threshold.

Here’s how it will work from 2023: If job insurance was prohibitive for a family, the worker would have to remain in the employer plan while the spouse and children would be covered by the marketplace — and eligible for subsidies, Cox said.

“That means families would be split across two or more health plans, which would mean multiple premiums and deductibles,” she said. “Not all people in the family breakdown will actually be better off switching to subsidized coverage.”

https://www.cnbc.com/2022/10/27/what-to-know-about-2023-health-insurance-marketplace-open-enrollment.html What you should know about the 2023 health insurance marketplace open registration

Chrissy Callahan

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