North Carolina Affordable Care Act Facts 2021
Essential facts about the Affordable Care Act (ACA or Obamacare) in North Carolina, including whether you must get health insurance, how much it will cost, and how you can save money.
What North Carolina Residents Need to Know About Obamacare for 2021
Updated: 2020-07-16 by
The Affordable Care Act, also known as Obamacare, has not been struck down or repealed. North Carolina open enrollment for 2021 plans runs from November 1 until December 15.
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 Healthcare.gov to compare plans, sign up for coverage, and get financial assistance.
This website provides information about getting health insurance under the 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 North Carolina:
1. Open enrollment for 2021 health insurance plans runs from Sunday, November 1, 2020 to Tuesday, December 15, 2020.
In North Carolina, you can sign up for 2021 health coverage from November 1 to December 15, 2020. If you enroll by December 15, your coverage will begin on January 1, 2021.
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 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 North Carolina.
2. 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 go without health insurance coverage, you won’t have to pay a penalty when you file your federal taxes.
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.) And if you miss open enrollment and find yourself needing coverage mid-year, you may have to wait until 2022 to get it.
3. Average premium rates are staying fairly stable and insurers are sticking with the marketplace, despite the difficulties of the Covid-19 pandemic.
For the past six years, Charles Gaba at ACAsignups.net has done a good job of predicting and tracking premium increases state by state and for the nation as a whole. He tracks the numbers for each state on this chart, updating it as new information becomes available. So far, only a couple of states are showing premium increases of more than 10%, while a number of states show average premium rates dropping for 2021.
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 North Carolina 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 Healthcare.gov.
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 North Carolina 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 Healthcare.gov 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 North Carolina.
For more information, see Ways to Save Money on Obamacare in North Carolina.
5. Beware insurance plans that don’t comply with the ACA!
In 2018, the Trump administration made it easier to purchase "short-term insurance plans" and a federal court upheld this move. 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 North Carolina.
6. 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. But that doesn't mean you have to fend for yourself when finding and signing up for health insurance. To connect with local support resources, see How To Sign Up for Obamacare in North Carolina.
You may also be interested in:
Where to go in North Carolina 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 North Carolina.
Learn the five factors that determine what residents of North Carolina will pay for health insurance under the Affordable Care Act