ACA Special Enrollment Period Extended Into August

President Joe Biden’s administration recently extended access to the Special Enrollment Period (SEP) for the Affordable Care Act (ACA) to Aug. 15, from the previously announced end date of May 15.  

This direction comes after the U.S. Department of Health and Human Services (HHS) opened this SEP for the Health Insurance Marketplace on Feb. 15, resulting in over 200,000 enrollments in the first two weeks. 

American Rescue Plan ACA Subsidies

This extension comes shortly after increased ACA subsidies were included as part of the American Rescue Plan Act (ARPA), which temporarily increases the dollar amount and expands eligibility for federal subsidies for health insurance coverage purchased through the Marketplace. 

Currently, the ACA’s premium tax credits are not available to individuals with income at or above 400% of the federal poverty level. The ARPA temporarily eliminates this income cap on these subsidies for two years.

The law also:

  • Limits the total amount a household would be required to pay for health coverage through the Exchanges to 8.5% of their household income;
  • Increases the federal subsidy amounts available for lower-income individuals, eliminating premium costs completely for these individuals in some cases; and
  • Includes additional federal funding intended to encourage states that did not previously expand their Medicaid programs to do so now.

These ACA changes are temporary, and will expire after a period of two years.

In addition, the ARPA eliminates the requirement to repay an excess advance payment of the premium tax credit for the 2020 tax year only. This means that, if a taxpayer’s advance payment of the premium tax credit exceeds the actual premium tax credit they are owed, no additional tax is imposed, regardless of household income.

What This Means

Paired with the ARPA, the Biden administration’s action to extend the SEP is intended to increase access to health care through the Marketplace.

While the SEP is currently open, the ARPA subsidies offering some consumers increased savings and lower costs will be available starting April 1. Consumers seeking to take advantage of this special enrollment period can visit www.HealthCare.gov to find out if they are eligible and learn more. 

FBinsure will keep you updated on any noteworthy health care and employee benefits changes.