In Iowa, Affordable Care Act (Obamacare) open enrollment for 2024 begins Wednesday, November 1, 2023 and ends January 15, 2024.
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 Iowa:
1. Open enrollment for 2024 begins Wednesday, November 1, 2023 and ends January 15, 2024
Iowa residents can sign up for 2024 health coverage from November 1, 2023 to January 15, 2024. For most people, if you enroll by December 15, your coverage will begin on January 1, 2024. If you enroll after December 15, your coverage will begin on February 1.
If you are currently uninsured, you can use Healthcare.gov 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 your plan is continuing, open enrollment is a good time to review your coverage, compare plans, and switch to a new one if you find a better option. If your insurance company stops offering your current health plan, they may "map" you onto a new plan. In this case, it's even more important for you to investigate your options to be sure you get the best plan for you.
To learn more about enrollment, see How To Sign Up for Obamacare in Iowa.
2. Once the Iowa open enrollment has ended, you may be able to use a special enrollment period to get covered.
Once open enrollment ends on January 15, 2024, you won't be able to get health insurance through Healthcare.gov until open enrollment for 2025 begins in the fall of 2024, unless you qualify for an exception or your income is low enough for Medicaid.
If you’ve lost your job or significant income in the past 60 days, you might qualify for a special enrollment period (SEP). A SEP allows you to sign up for a new health insurance plan or change your current one outside the open enrollment window.
In addition to job or income loss, many other qualifying events may make you eligible for a SEP. To learn more, see What Happens If I Miss the Iowa Obamacare Enrollment Deadline?
2. If you lose Medicaid or CHIP coverage due to the end of federal pandemic protections, there's a SEP just for you.
The federal government will initiate an "Unwinding SEP" on April 1, 2023 for those kicked off of Medicaid or CHIP due to expiring COVID-related policies. Losing Medicaid or CHIP coverage always makes you eligible for a 60-day Special Enrollment Period, but this SEP lets you enroll in an ACA plan for up to 16 months, through July 31, 2024.
3. You won’t face a tax penalty for going without health insurance in 2024—but there are big downsides to being uninsured.
Obamacare’s tax penalty went away in 2019. That means that if you don’t have health insurance, you won’t have to pay a penalty when you file your federal income taxes. That said, think 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. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.)
In 2021, President Biden signed the American Rescue Plan Act (ARPA). The law provided $1.9 trillion of federal aid to Americans struggling with the COVID-19 crisis, including additional premium subsidies for those who purchase health insurance through Healthcare.gov. In 2022, the Inflation Reduction Act extended these more generous subsidies through 2025. Here’s a quick summary of the types of available subsidies.
Federal tax credits. Under ARPA, no one will have to pay more than 8.5% of their household income for a mid-level plan purchased from Healthcare.gov. Technically, the subsidies are tax credits, but you can choose to have them automatically deducted from the cost of your monthly premiums.
Cost-sharing subsidies. More than half of the people who purchase coverage through Healthcare.gov receive assistance through cost-sharing reductions (CSRs). CSRs automatically reduce your premiums and lower your costs when you use your insurance benefits—for example, when you go to the doctor, get lab work, or have to stay in the hospital.
CSRs are available to people who make between 100% and 250% of the federal poverty level. (For 2023 health plans, that means a family of four in Iowa can't earn more than $75,000 and an individual not more than $36,450.) But these benefits are available only on silver plans. If you think you may qualify, look carefully at the costs for silver plans available at Healthcare.gov while shopping for coverage.
Medicaid. You may qualify for free or low-cost coverage through Medicaid in Iowa if your income is very low.
All subsidies will be automatically calculated when you apply for a plan through Healthcare.gov.
For more information, see Ways to Save Money on Obamacare in Iowa.
5. Avoid short-term insurance plans that don’t comply with the ACA.
In 2018, the Trump administration made purchasing short-term insurance plans easier. 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.
If you’re genuinely caught without health insurance and need it for a few months to cover a new health condition, you might want to consider a true short-term plan to get you through to the next open enrollment period. Otherwise, be careful of plans that don’t meet the requirements of the Affordable Care Act, and shop around to look for coverage that truly meets your needs.
Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in Iowa.
6. You can get help signing up if you need it.
The Biden administration has greatly increased enrollment assistance, 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 Iowa.