Maryland Obamacare (Affordable Care Act) Facts 2021

What Maryland Residents Need to Know About Obamacare for 2021

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


Updated: 2021-02-16 by

It's not too late! Affordable Care Act (Obamacare) enrollment will be OPEN in Maryland until March 15, 2021.

Maryland has announced a special enrollment period for health plan signups under the Affordable Care Act (Obamacare). This COVID-related enrollment period is open until March 15 and is available to all uninsured Maryland 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 Maryland:

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

Maryland Health Connection has opened a COVID-related special enrollment period until March 15, 2021. You may use this opportunity to sign up for health insurance if you are currently uninsured. When your coverage starts depends on when you sign up.

  • If you sign up from January 4-15, your coverage is backdated to January 1.
  • If you sign up from January 16 to February 15, your coverage starts February 1.
  • If you sign up from February 16 to March 15, your coverage begins March 1.

Note that this special enrollment period in Maryland differs from the SEP announced by the Biden administration for the federal health insurance marketplace. The federal SEP is open until May 15. Given the generous history of Maryland Health Connection, there's a good chance they will extend the Maryland SEP. We'll update this article if that happens.

To learn more about enrollment, see How To Sign Up for Obamacare in Maryland.

2. Your health insurance marketplace is located at Maryland Health Connection.

During open enrollment, or whenever you qualify for an exception, you can use the website Maryland Health Connection to choose your health insurance plan, apply for cost-saving tax credits, and get other help you need.

To learn more about enrollment, see How Do I Sign Up for Obamacare in Maryland?

3. You won’t face a tax penalty for going without health insurance in 2021—but there are big downsides to being uninsured.

Obamacare’s tax penalty went away in 2019. That means that if you go without health insurance coverage, you won’t have to pay a penalty when you file your federal taxes this year.

Even though there's no more tax penalty, think hard about whether it makes sense to forego health insurance. A medical crisis could knock the financial wind from your sails and do more damage than the penalty would. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.) And if you miss open enrollment and find yourself needing coverage mid-year, you may have to wait until 2022 to get it.

4. In 2021, more plans are available in Maryland and average premiums have decreased.

In Maryland, average premium rates for 2021 health plans sold at Maryland Health Connection dropped by almost 12%. This is the third year in a row of declining rates for Marylanders, primarily due to a tax that Maryland imposes on insurance carriers; the tax money is put into a fund that helps insurers cover unusually expensive claims. This is known as a "reinsurance program."

Maryland residents will also find a new insurer offering plans on the exchange for 2021. UnitedHealthcare joins CareFirst and Kaiser to provide additional options for many people. However, there will still be eight Maryland counties with plans available from only one insurance company.

5. 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 Maryland 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 Maryland Health Connection.

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 Maryland 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 Maryland Health Connection 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 Maryland.

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

6. Maryland limits "short-term insurance plans" to fewer 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. In Maryland, however, short-term plans must last fewer than three months and they cannot be automatically renewed.

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 Maryland.

7. 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 Maryland.


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