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Washington Obamacare (Affordable Care Act) Facts 2021

What Washington State Residents Need to Know About Obamacare for 2021

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

Washington 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, and it applies to "anyone seeking health insurance."

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 Washington:

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, Washington Healthplanfinder will be open for new Obamacare signups between February 15 and May 15, 2021. If you currently need health insurance, 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 Washington.

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 Washington Obamacare Enrollment Deadline?

2. For 2021, Washington offers a public option for health insurance in 20 counties.

As of January 1, 2021, Washington became the first state in the country to offer a public option for health insurance, called Cascade Care. In this first year of its implementation, Cascade Care public option plans are available in only 20 of Washington's 39 counties. (One public option plan will be available in King County, which includes Seattle.)

Washington's public option program looks different from what most people think of as a "public option," because the state doesn't actually provide the insurance. Instead, the state controls the terms and manage the costs, while private insurance companies deliver the plans themselves.

The new program isn't expected to lead to dramatic savings for consumers but, if it works as expected, it will stem the tide of rising costs.

3. Average premium rates dropped for the second year in a row and more insurance providers have joined the marketplace.

For 2021, thirteen insurance companies are offering plans through Washington Healthplanfinder, giving Washingtonians more choice of plans than ever before. Every county will have at least two insurance carriers to choose from. Average premium rates dropped by more than 3% for the second year in a row.

4. Premium subsidies are available to save you money.

Several forms of financial assistance can help you lower your health insurance premiums. In addition to the currently available subsidies listed below, Washington is considering the addition of state premium subsidies for those with income levels up to 500% of the federal poverty level, but these wouldn't begin until 2022.

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 Washington 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 Washington Healthplanfinder.

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 Washington 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 Washington Healthplanfinder while you are shopping for coverage.

Medicaid. If your income is very low, you may qualify for free or low-cost coverage through Apple Health in Washington.

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

5. 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 didn’t have health insurance coverage in 2020, you won’t have to pay a penalty when you file your taxes this year.

However, 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.) Even if you missed open enrollment for 2021, special circumstances may allow you to obtain coverage.

6.  Insurers don't sell short-term insurance plans in Washington.

In 2018, the Trump administration made it easier to purchase short-term insurance plans. Short term plans don’t have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. In the past, short-term plans were allowed to last only three months but under new rules you can purchase a non-ACA compliant “short term” plan that lasts as long as three years. In Washington, however, short-term health plans are still limited to three months and they are not renewable. Currently, no insurer is offering short-term plans in the state.

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

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 Washington.

 

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Seattle, WA: Law