What New Jersey Residents Need to Know About Obamacare for 2020
The Affordable Care Act, also known as Obamacare, has not been struck down or repealed.
As of January 2020, the ongoing federal court case challenging the ACA is still moving through the courts. The penalty for being uninsured has been struck down but the rest of the law remains in effect.
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 New Jersey:
1. New Jersey law requires you to have health insurance.
The federal tax penalty for going without health insurance ended in 2019, but a handful of states, including New Jersey, have enacted laws to replace it. The requirement, called the "state shared responsibility tax," says that New Jersey residents must have health insurance that meets the requirements of the Affordable Care Act or face a state tax penalty. (For more information about penalty amounts, see the website of the New Jersey Treasury. You can find the law itself in the New Jersey Health Insurance Market Preservation Act of 2018.)
To find out whether you qualify for an exemption to the health insurance requirement, see Do I Have to Get Health Insurance in New Jersey?
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 New Jersey, the ACA open enrollment period ended on December 18, 2019. This means that, unless you qualify for an exception, you won't be able obtain health insurance through HealthCare.gov 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 New Jersey Obamacare Enrollment Deadline?
3. Your health insurance marketplace is located at HealthCare.gov.
During open enrollment, or whenever you qualify for an exception, you can use the website HealthCare.gov 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 New Jersey?
4. After dropping last year, rates are rising again for 2020—but most will remain lower than they were in 2018.
After an average 9.3% decrease last year, rates for New Jersey individual insurance plans are climbing again. Plans sold by Horizon Blue Crosss and Blue Shield will rise an average of 6.5%. AmeriHealth plans are set to go up 11%. Oscar premiums will shoot higher than the others, up 16.8%.
New Jersey continues to use HealthCare.gov for 2020 signups but expects to bring its own health insurance exchange on line next year, in time for 2021 open enrollment.
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 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 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 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 New Jersey.
For more information, see Ways to Save Money on Obamacare in New Jersey.
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. 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 New Jersey.
You may also be interested in:
Where to go in New Jersey 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 New Jersey.
Learn the five factors that determine what residents of New Jersey will pay for health insurance under the Affordable Care Act