Updated: 2021-04-19 by
It's not too late! Affordable Care Act (Obamacare) enrollment is OPEN in New Jersey until December 31, 2021.
New Jersey has announced an extended enrollment period for health plan signups under the Affordable Care Act (Obamacare). This COVID-related enrollment period is open until the end of 2021 and is available to all New Jersey residents who need coverage.
Also, a new federal law, The American Rescue Plan Act of 2021 (ARPA), increases premium subsidies, provides free health insurance if you’re unemployed in 2021, and waives excess subsidy payments for the 2020 tax year. If you qualify for new financial benefits under ARPA, you can go to GetCoveredNJ to sign up.
This website provides information about the new programs available under ARPA as well as other facts 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 how the penalty works, including penalty amounts, see the website of the New Jersey Treasury.)
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. You can use the COVID special enrollment period to get covered under the Affordable Care Act, even though open enrollment is over.
Because of the COVID-19 pandemic, GetCoveredNJ will be open for new Obamacare signups until December 31, 2021. This extension of the state's usual open enrollment period allows all New Jersey residents to get health coverage and benefit from new financial assistance programs.
To learn more about enrollment, see How To Sign Up for Obamacare in New Jersey.
3. You may qualify for new health insurance premium subsidies.
On March 11, 2021, President Biden signed the American Rescue Plan Act. The law provides $1.9 trillion of federal aid to Americans still struggling with the COVID-19 pandemic. The relief measures include additional premium subsidies for those who purchase health insurance under the Affordable Care Act. Also, New Jersey is offering new state financial assistance for 2021. Here's a quick summary of the programs available to you:
Federal tax credits. Until the passage of ARPA, the ACA provided premium subsidies only for those whose income fell between 100% and 400% of the federal poverty level. (For example, the cutoff for a family of four in New Jersey was $104,800. For an individual, it was $51,040.)
Now, no individual or family will have to pay more than 8.5% of their household income for a mid-level “silver” plan purchased from GetCoveredNJ. Even though the amount of the subsidy is based on a silver plan, you can apply the subsidy to any marketplace plan, including bronze, gold, or platinum plans. The subsidies are tax credits, but you can choose to have them automatically deducted from the cost of your monthly premiums when you purchase a plan through GetCoveredNJ.
Even though New Jersey is allowing only uninsured people to enroll during the COVID-related enrollment window, you should still be able to switch to a silver plan at GetCoveredNJ. That's because becoming eligible for new subsidies is a qualifying event that will allow you to buy or change plans outside of open enrollment. Keep in mind, however, that you have only 60 days to act after you become newly eligible.
These enhanced subsidies are retroactive to the start of 2021, but they're also temporary. They will last only through 2022 unless Congress enacts legislation to extend them.
Cost-sharing subsidies. More than half of the people who purchase coverage through a health insurance exchange receive "cost-sharing reductions" (CSRs). These subsidies 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 2021 health plans, that means a family of four in New Jersey can't earn more than $65,500 and an individual not more than $25,520.) Keep in mind that cost-sharing subsidies are available only on silver plans. If you think you may qualify, look carefully at costs for the silver plans available at GetCoveredNJ while you are shopping for coverage.
New Jersey health plan savings. Beginning in 2021, New Jerseyans earning under 400% of the federal poverty level will get additional financial help. Individuals may be able to lower their insurance costs by up to $578 per year, while a family of four may see their annual cost drop by as much as $2,313. You'll find out whether you qualify when you apply for health coverage through GetCoveredNJ. This new program is funded by a 2.5% tax on individual and large group health plans sold in New Jersey.
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.
4. If you are unemployed in 2021, you qualify for free health insurance.
If you receive unemployment benefits for at least one week in 2021, the American Rescue Plan guarantees that you can receive a mid-level silver plan for 2021 at no cost to you. This is because the law will disregard any income you earn over 133% of the federal poverty level. And that, in turn, will lock in the highest level of premium assistance for you. If you get a job, your eligibility will change. You’ll be able to apply for this benefit when you purchase an insurance plan through GetCoveredNJ. Be prepared to prove that you are receiving or have received unemployment compensation this year.
As an alternative, from April through September of 2021, ARPA provides for 100% free coverage under COBRA for those who have been laid off or subject to a reduction of hours great enough to trigger COBRA eligibility. Speak to your former employer about this benefit; for more information about COBRA, see the U.S. Department of Labor website.
5. If you owed excess premium subsidies for 2020, you don’t have to pay.
Did you expect to owe the IRS for excess health insurance premium subsidies you received last year? The American Rescue Plan Act says you don’t have to pay back the money.
If your subsidy assistance fell short of your eligibility, you can still claim the additional amount owed to you when you file your taxes. But if your subsidy amount was too large, you get a free pass this year—and only this year. In other words, don’t underestimate your income when you purchase a 2021 plan because you hope for a similar break next year.
Because this rule is new and tax season is upon us, you may need to call your tax preparer for help. It’s not yet clear, for example, what you should do if you’ve already filed your 2020 tax return and repaid your excess tax credit. If you’re not sure what to do, you can always request an extension to file your taxes, giving you until October 15 to sort it out.
6. You can get help signing up if you need it.
A couple of years back, the Trump administration drastically cut funding for programs that provide help with health insurance enrollment. But the Biden administration is expected to quickly reverse that trend, 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 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