The ACA marketplace looks different this year– Here’s how you could benefit

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by Matt Petras, PublicSource

One of the most common criticisms of the Affordable Care Act [ACA] is that it really hasn’t made health insurance affordable for consumers as it promised. 

However, because of the American Rescue Plan Act [ARPA], many more people buying health insurance in the marketplace are eligible for new subsidies that significantly drive down costs. 

Bill Tuthill, Highmark’s senior vice president of federal markets, has focused almost exclusively on the insurance company’s ACA marketplace since the law’s origins in 2009, and he finds the ARPA exciting. 

“For the average consumer, the way that a consumer is experiencing the Affordable Care Act, I would feel very confident saying that the American Rescue Plan Act is the biggest step toward fulfilling that promise since the original passage of the law,” Tuthill said.

Both Highmark and UPMC, the largest providers of health insurance in Western Pennsylvania, say that customers can expect more affordable options for health insurance during the current round of open enrollment. And it appears that, so far, many people are opting for plans with better benefits now that prices are more affordable. 

Because of the ACA, shopping for private insurance plans occurs on a government-regulated and subsidized online marketplace. Enrollment for 2022 health insurance plans in the ACA marketplace began Nov. 1 and runs through Jan. 15. To get a plan that begins by Jan. 1, the deadline is Dec. 15. 

What subsidies are available?

The ARPA, a $1.9 trillion pandemic-response bill signed into law by President Joe Biden in March, adds a series of subsidies for individuals who buy their own private insurance, as opposed to an employer-based plan, Medicaid or Medicare. 

One substantial change: Individuals with incomes up to 150% of the federal poverty line [FPL] can take advantage of tax credits to enroll in a Silver plan for free. For example, individuals who make $19,320 or a family of four that makes $39,750 are at 150% of the FPL. A Silver plan pays for about 70% of healthcare costs, as opposed to 60% for Bronze plans, 80% for Gold and 90% for Platinum. 

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