New York Obamacare (Affordable Care Act) Facts 2020

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


What New York Residents Need to Know About Obamacare for 2020


UPDATE: Due to the coronavirus (COVID-19) outbreak, NY State of Health 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 New York:

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 coronavirus (COVID-19) outbreak, NY State of Health is OPEN until April 15 for new health insurance signups.]

In New York, the ACA open enrollment period ended on January 31, 2020. This means that, unless you qualify for an exception, you won't be able obtain health insurance through NY State of Health 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 York 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 NY State of Health.

During open enrollment, or whenever you qualify for an exception, you can use the website NY State of Health 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 York?

4. Insurers are sticking with the marketplace and cost increases continue to slow down.

In New York, 12 insurers will offer marketplace plans for 2020. In addition, premium increases have slightly slowed. This year's average rate increase for individual plans will be 6.8%, as compared to last year's jump of 8.6%. As the New York Department of Financial Services, overall rates for individual health insurance plans are now 55% lower than they were prior to the establishment of NY State of Health in 2014.

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 NY State of Health.

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 NY State of Health 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 York.

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

6. New York does not allow short-term health plans.

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. This is not true in New York, however. New York state law forbids short-term health insurance plans altogether.

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 New York 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 New York.

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