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California Obamacare (Affordable Care Act) Facts 2021

What California Residents Need to Know About Obamacare for 2021

Essential facts about the Affordable Care Act (ACA or Obamacare) in California, including whether you must get health insurance, how much it will cost, and how you can save money.

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Updated: 2021-02-16 by

It's not too late! Affordable Care Act (Obamacare) enrollment will be OPEN in California until May 15.

California has announced a special enrollment period (SEP) for health plan signups under the Affordable Care Act (Obamacare). This COVID-related enrollment period will run from February 1 to May 15, 2021. It mirrors the federal special enrollment period announced by the Biden administration, but the California SEP applies only to those who are currently uninsured.

This website provides information about getting health insurance under the ACA, including:

To begin, keep in mind these key points about health insurance in California:

1. You can use the COVID special enrollment period to get covered under the Affordable Care Act, even though open enrollment is over.

Because of the COVID-19 pandemic, Covered California will be open for new Obamacare signups until May 15, 2021. If you are currently uninsured, you can use this special enrollment period to get covered for 2021. To learn more about enrollment, see How To Sign Up for Obamacare in California.

If you already have health insurance. If you're already insured, you can change plans only if you have a "qualifying life event." Otherwise, you must wait until open enrollment for 2022 plans begins in the fall of 2021. To learn whether you qualify for a special enrollment period that will allow you to switch plans, see What Happens If I Missed the California Obamacare Enrollment Deadline?

2. California law requires you to have health insurance.

The federal tax penalty for going without health insurance ended in 2019, but a handful of states, including California, have enacted laws to replace it. If you are uninsured in 2020 and you don't qualify for an exemption, you'll face a penalty when you file your California taxes in 2021.

To learn more about the penalty and to find out whether you qualify for an exemption, see Do I Have to Get Health Insurance in California?

3. Insurers are sticking with the marketplace and premium rates are stable, despite the Covid-19 pandemic.

In California, all 11 insurers in the marketplace are continuing to offer plans for 2021, and Anthem Blue Cross and Oscar will offer plans in more counties. This means that most Californians will be able to choose between three or more insurers. Even better, rates for California insurance coverage are set to go up an average of just 0.6%.

A press release from Covered California stated that the pandemic will have "little effect on the total costs of care in California's individual market for 2020 and 2021."

4. New California state subsidies are available to save you money.

More people than ever who sign up for insurance through Covered California will be eligible for premium subsidies. In addition to the existing Affordable Care Act subsidies for those with very low incomes, California is now offering subsidies to help middle-income people pay less for coverage.

Federal premium subsidies. The federal government provides help with premium payments for those whose incomes fall between 100% and 400% of the federal poverty level. The federal government provides help with premium payments for those whose incomes fall between 100% and 400% of the federal poverty level. For example, for 2021 health plans, a family of four in California earning as much as $104,800 can qualify for subsidies, as can an individual who earns up to $51,040. Though these subsidies are technically tax credits, they are automatically deducted from the cost of your premiums each month, as long as you purchase your plan through Covered California.

California state subsidies. Beginning in 2020, three groups of consumers will benefit from new subsidies offered in California health plans:

  • Californians who earn between 400% and 600% of the federal poverty level will be eligible to save an average of 23% on their monthly premiums. For 2021, 600% of the federal poverty level is $76,560 for an individual and $157,200 for a family of four.
  • Those earning between 100% and 400% of the federal poverty level (see above) will be eligible to receive state subsidies in addition to federal assistance. The state subsidy will contribute additional average savings of 5% on monthly premiums.
  • State residents whose annual household income is less than 138% of the federal poverty level will see premiums for certain plans lowered to just $1 per person, per month. The 2021 earnings cutoff for this level is $17,609 for an individual and $36,156 for a family of four.

Those with very low income may continue to qualify for free or low-cost coverage through Medicaid in California (Medi-Cal). Eligibility for subsidies or Medi-Cal will be automatically determined when you sign up for coverage at Covered California.

For more information, see Ways to Save Money on Obamacare in California.

5. California has banned the sale of "short-term insurance plans" lasting more than 12 months.

In 2018, the Trump administration made it easier to purchase short-term insurance plans. These plans don't have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. The new federal rules say that short-term plans can last for as long as three years. But California placed its own limits on the expansion of short-term plans. Under California law, insurers may not sell short-term plans lasting longer than 12 months.

If you’re genuinely caught without health insurance and need it for a few months to cover a new health condition, you might want to consider a short-term plan to get you through to the next open enrollment period. Otherwise, be careful of plans that don’t meet the requirements of the Affordable Care Act. Shop around to look for coverage that truly meets your needs.

Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in California.

6. You can get help signing up if you need it.

A couple of years back, the Trump administration drastically cut funding for programs that provide help with health insurance enrollment. But the Biden administration is expected to quickly reverse that trend, making it much easier to get the information you need to get covered. To connect with local support resources, see How To Sign Up for Obamacare in California.

 

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Oakland, CA: Law