New York Obamacare (Affordable Care Act) Facts 2021

What New York Residents Need to Know About Obamacare for 2021

Essential facts about the Affordable Care Act (ACA or Obamacare) in New York, 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 is OPEN in New York until March 31.

New York has extended its open enrollment for health plan signups under the Affordable Care Act (Obamacare). This COVID-related extension will last until at least March 31, and it applies to all uninsured New York 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 New York:

1. Open enrollment for 2021 health insurance plans is open until March 31, 2021.

In New York, you can sign up for 2021 health coverage until March 31, 2021. This three-month extension of the state's usual open enrollment period allows those impacted by the COVID-19 pandemic to get health coverage, though anyone eligible to use NY State of Health can enroll in a plan or change plans during this time.

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

2. 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.

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.

3. Insurers are sticking with the marketplace and average cost increases are the lowest ever approved.

In New York, all 12 insurers from 2020 will continue to offer marketplace plans for 2021. In addition, after insurers initially proposed average rate increases of almost 12%, the New York Department of Financial Services (NYDFS) approved an overall average rate that turned out to be just 1.8%.

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 New York 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 NY State of Health.

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 New York 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 NY State of Health 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 New York.

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

5. New York does not allow short-term health plans.

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. This is not true in New York, however. New York state law forbids short-term health insurance plans altogether.

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 New York.


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