Maryland Obamacare (Affordable Care Act) Facts 2020

Essential facts about the Affordable Care Act (ACA or Obamacare) in Maryland, including whether you must get health insurance, how much it will cost, and how you can save money.

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What Maryland Residents Need to Know About Obamacare for 2020

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UPDATE: Due to the coronavirus (COVID-19) outbreak, Maryland Health Connection is OPEN until April 15 for new health insurance signups.

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 Maryland:

1. Open enrollment has ended for 2020 health care plans, but you can still get health insurance if you qualify for a special enrollment period.

[UPDATE: Due to the COVID-19 outbreak, Maryland Health Connection is OPEN until April 15 for new health insurance signups.]

In Maryland, the ACA open enrollment period ended on December 15, 2019. This means that, unless you qualify for an exception, you won't be able obtain health insurance through Maryland Health Connection 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 Maryland Obamacare Enrollment Deadline?

2. You won’t face a tax penalty for going without health insurance in 2020—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 2019, you won’t have to pay a penalty when you file your taxes in this year.

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've missed open enrollment for 2020, special circumstances may allow you to obtain coverage.

3. Your health insurance marketplace is located at Maryland Health Connection.

During open enrollment, or whenever you qualify for an exception, you can use the website Maryland Health Connection 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 Maryland?

4. Insurers are sticking with the marketplace and premiums are decreasing.

In Maryland, CareFirst and Kaiser will continue to offer marketplace plans for 2020. Even better, most monthly premiums dropped for the second year in a row. For the coming year, most Marylanders will see a drop of almost 15%, while others will see decreases of 1.45% to 5%, depending on their plan. The decreases are primarily the result of a tax that Maryland imposes on insurance carriers; the tax money is put into a fund that helps insurers cover unusually expensive claims. This is known as a "reinsurance program.

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 Maryland Health Connection.

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 Maryland Health Connection 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 Maryland.

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

6. Maryland limits "short-term insurance plans" to fewer 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. In Maryland, however, short-term plans must last fewer than three months and they cannot be automatically renewed.

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 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. 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 Maryland

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

A couple years back, the Trump administration drastically cut funding for the programs that provide enrollment assistance. It also killed the budget for promoting the federal health insurance exchange. The good news is that Maryland doesn't rely on federal funding for its outreach and enrollment assistance programs so you still have plenty of options for free help.

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 Maryland.


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