Rhode Island Obamacare (Affordable Care Act) Facts 2021

What Rhode Island Residents Need to Know About Obamacare for 2021

Essential facts about the Affordable Care Act (ACA or Obamacare) in Rhode Island, 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 Rhode Island from February 15 to May 15.

Rhode Island 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 15 to May 15. It mirrors the federal special enrollment period announced by the Biden administration, but the Rhode Islands SEP applies only to those who are currently uninsured.

This website provides information about getting health insurance under the Affordable Care Act (ACA), including:

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

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, Health Source RI will be open for new Obamacare signups between February 15 and 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 Rhode Island.

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 Rhode Island Obamacare Enrollment Deadline?

2. Rhode Island 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 Rhode Island, have enacted laws to replace it. Beginning in January 2020, Rhode Island residents must have health insurance that meets the requirements of the Affordable Care Act or face a state tax penalty, unless they qualify for an exemption.

To learn more about Rhode Island's health insurance requirement and to find out whether you qualify for an exemption, see Do I Have to Get Health Insurance in Rhode Island?

3. Rhode Island's health insurance marketplace is located at Health Source RI.

During open enrollment, or whenever you qualify for a special enrollment period, you can use Health Source RI 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 Rhode Island?

4. For 2021, you'll find the same insurers in the marketplace but the average monthly premium increase is steeper than last year's.

Both insurers in the Rhode Island marketplace will remain in place for 2021 and monthly premiums will rise more this year than last. Average rates for Neighborhood Health Plan will increase 4.7% and plans for Blue Cross Blue Shield will rise an average of 3.3%. You can find a full report on Rhode Island health care rates in this press release from the Rhode Island Health Commissioner's Office.

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 Rhode Island 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 Health Source RI.

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 Rhode Island 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 Health Source RI 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 Rhode Island.

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

6. No Insurers Sell Short-Term Plans in Rhode Island.

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. States can make their own rules, however, and the federal changes will have little effect in Rhode Island. The state requires all insurance plans to meet strict standards, including coverage of preexisting conditions and a comprehensive package of benefits. For this reason, no insurers are offering short-term health insurance plans in Rhode Island.

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 Rhode Island.


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