What District of Columbia Residents Need to Know About Obamacare for 2020
UPDATE: Due to the coronavirus (COVID-19) outbreak, DC Health Link is OPEN for new health insurance signups.
This website provides information about getting health insurance under the Affordable Care Act (ACA), including:
- whether you must get health insurance
- what the available plans cover
- how much coverage will cost
- how to sign up for a plan
- how to get help if you need it.
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 Tax Payer Health Insurance Responsibility Requirement, says that D.C. residents must have health insurance that meets the requirements of the Affordable Care Act.
If you are uninsured and you don't qualify for an exemption, you'll face a state tax penalty for going without health insurance in 2020. To learn 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 has ended for 2020 health care plans, but you can still get health insurance if you qualify for a special enrollment period.
In the District of Columbia, the ACA open enrollment period ended on January 31, 2020. This means that, unless you qualify for an exception, you won't be able obtain health insurance through DC Health Link until the 2021 open enrollment period begins in the fall of 2020.
To learn whether you qualify for an exception that will let you get covered, see What Happens If I Missed the District of Columbia Obamacare Enrollment Deadline?
3. Your health insurance marketplace is located at DC Health Link.
During open enrollment, or whenever you qualify for an exception, you can use the website DC Health Link 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 the District of Columbia?
4. Insurers are sticking with the marketplace and cost increases have slowed.
In D.C., all marketplace insurers are expected to remain in place for 2020. What may be even better, premium increases are slowing down. The average increase for individual marketplace plans will be 7.6%. That's down from 13% last year.
5. 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 2020, for example, a family of four earning as much as $103,000 can qualify for subsidies, as can an individual who earns up to $49,960. 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 as no more than 250% of the federal poverty level. (For 2020, that means a family of four can't earn more than $64,375 and an individual not more than $24,980.) 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.
An insurance agent or broker may be the best bet for sorting out your options. To find one or to learn about other support resources available to you, see How To Sign Up for Obamacare in the District of Columbia.
You may also be interested in:
Where to go in District of Columbia to get health plans under the Affordable Care Act (Obamacare) and how to get help with the application process.
Learn whether you must have health coverage under the Affordable Care Act (Obamacare) in District of Columbia.
Learn the five factors that determine what residents of District of Columbia will pay for health insurance under the Affordable Care Act