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D.C. Obamacare (Affordable Care Act) Facts 2021

What District of Columbia Residents Need to Know About Obamacare for 2021

Essential facts about the Affordable Care Act (ACA or Obamacare) in District of Columbia, 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 is OPEN in D.C.

The District of Columbia has announced an ongoing special enrollment period (SEP) for health plan signups under the Affordable Care Act (Obamacare). This COVID-related enrollment period will last for the duration of the pandemic, and it applies to all uninsured D.C. residents.

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

To begin, keep in mind these key points about health insurance in the District of Columbia:

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, DC Health Link is still open for new Obamacare signups. If you're 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 the District of Columbia.

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 District of Columbia Obamacare Enrollment Deadline?

2. District of Columbia law requires you to have health insurance.

The federal tax penalty for going without health insurance ended in 2019. But the District passed a law to take its place. The health insurance mandate, called the Individual Responsibility Requirement, requires D.C. residents to have health insurance that meets the requirements of the Affordable Care Act, get an exemption, or pay a penalty when they file D.C. taxes.

To learn more about the D.C. insurance requirement and find out whether you qualify for an exemption, see Do I Have to Get Health Insurance in the District of Columbia?

3. For 2021, insurers are sticking with the marketplace and premium costs are stable.

In D.C., all marketplace insurers will remain in place for 2021. Perhaps even better, according to this press release, the average premium rate increase for plans offered on DC Health Link is just 0.2%.

4. Premium subsidies are available to save you money.

Several forms of financial assistance can help you lower your health insurance premiums.

Federal tax credits. 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 the District of Columbia earning as much as $104,800 can qualify for subsidies, as can an individual who earns up to $51,040. Though the subsidies are tax credits, they are automatically deducted from the cost of your premiums each month, as long as you purchase your plan through DC Health Link.

Cost-sharing reductions. More than half of the people who purchase coverage through a health insurance exchange receive "cost-sharing reductions" (CSRs). Originally, these were payments the federal government made to insurance companies that allowed them to reduce deductibles and co-payments for lower-income Americans. In 2017, the Trump administration stopped paying for CSRs, but insurers and many state regulators found a creative way to keep the program alive—adding the costs to silver marketplace plans through a practice called “silver loading”—so CSR benefits remain available for 2020 insurance plans.

Keep in mind that cost-sharing subsidies are available only on silver plans. They will automatically reduce your premium if your income is no more than 250% of the federal poverty level. (For 2021 health plans, that means a family of four in the District of Columbia can't earn more than $65,500 and an individual not more than $25,520.) If you think you may qualify, look carefully at costs for the silver plans available at DC Health Link while you are shopping for coverage.

Medicaid. If your income is very low, you may qualify for free or low-cost coverage through Medicaid in the District of Columbia.

For more information, see Ways to Save Money on Obamacare in the District of Columbia.

5. The District of Columbia has banned the sale of "short-term insurance plans" lasting more than three 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 D.C. placed its own limits on the expansion of short-term plans. Under District law, insurers may not sell short-term plans lasting longer than three months, without renewals. As a result, most insurers in the District have stopped selling short-term plans.

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

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 the District of Columbia.

 

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Washington, DC: Law