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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.

Updated: 2020-07-16 by

The Affordable Care Act, also known as Obamacare, has not been struck down or repealed. the District of Columbia open enrollment for 2021 plans runs from November 1 until January 31.

The news has been full of uncertainty about the future of the Affordable Care Act (Obamacare) as the law once again sits before the U.S. Supreme Court. However, a ruling on that case is still many months away and chaotic political winds could shift and affect the law before that time. For 2021 health plans, you can use DC Health Link to compare plans, sign up for coverage, and get financial assistance.

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. 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?

2. Open enrollment for 2021 health insurance plans runs from Sunday, November 1, 2020 to Sunday, January 31, 2021.

In the District of Columbia, you can sign up for 2021 health coverage from November 1 to January 31, 2021. If you enroll by December 15, your coverage will begin on January 1, 2021.

If you still need coverage for 2020, D.C. will let you enroll in a 2020 insurance plan at any time between now and December 31 because of the Covid-19 pandemic.

If you are currently uninsured, you can use DC Health Link to compare plans and enroll in a plan that meets your needs. 

If you already have health insurance, you will be automatically re-enrolled in your existing plan if it is still available. Even if you can continue in the plan you have now, open enrollment lets you review your coverage, compare plans, and switch to a new one if you find a better option.

To learn more about enrollment, see How To Sign Up for Obamacare 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 are expected to 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.

Fedral 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 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.

6. 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.

7. You can get help signing up if you need it.

A couple years back, the Trump administration drastically cut funding for  programs that provide help with health insurance enrollment. It also killed the budget for promoting the federal health insurance exchange. But that doesn't mean you have to fend for yourself when finding and signing up for health insurance. To find local support resources, see How To Sign Up for Obamacare in the District of Columbia.

 

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District of Columbia: Law