What Pennsylvania Residents Need to Know About Obamacare for 2024

 

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

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Pennsylvania open enrollment for 2024 health insurance plans runs from November 1, 2023 until January 15, 2024.

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 Pennsylvania:

 

1. Open enrollment for 2024 health insurance plans runs from Tuesday, November 1, 2023 through Sunday, January 15, 2024.

Pennsylvania residents can sign up for 2024 health coverage from November 1, 2023 to January 15, 2024. For most people, if you enroll by December 15, your coverage will begin on January 1, 2024. If you enroll after December 15, your coverage will start on February 1.

Once open enrollment has ended, you can get covered for the rest of the year only if you qualify for a special enrollment period, including job or income loss. 

If you're uninsured, you can use Pennie 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 your plan is continuing, open enrollment is an excellent time to review your coverage, compare plans, and switch to a new one if you find a better option. If your insurance company stops offering your current health plan, they may "map" you onto a new plan. In this case, it's vital that you to investigate your options to be sure you get the best plan for you. 

To learn more about enrollment, see How To Sign Up for Obamacare in Pennsylvania.

 See also: What Happens If I Miss the Pennsylvania Obamacare Enrollment Deadline?

2. You won’t face a tax penalty for going without health insurance in 2023—but there are big downsides to being uninsured.

Obamacare’s tax penalty went away in 2019. That means that if you don’t have health insurance, you won’t have to pay a penalty when you file your federal income taxes. That said, think 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. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.)

 3. You may qualify for new Affordable Care Act subsidies.

In 2021, President Biden signed the American Rescue Plan Act (ARPA). The law provided $1.9 trillion of federal aid to Americans struggling with the COVID-19 crisis, including additional premium subsidies for those who purchase health insurance through Pennie. In 2022, the Inflation Reduction Act extended these more generous subsidies through 2025. Here’s a quick summary of the types of available subsidies.

Federal tax credits. Under ARPA, no one will have to pay more than 8.5% of their household income for a mid-level plan purchased from Pennie. Technically, the subsidies are tax credits, but you can choose to have them automatically deducted from the cost of your monthly premiums.

Cost-sharing subsidies. More than half of the people who purchase coverage through Pennie receive assistance through cost-sharing reductions (CSRs). CSRs 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 2023 health plans, that means a family of four in Pennsylvania can't earn more than $75,000 and an individual not more than $36,450.) But these benefits are available only on silver plans. If you think you may qualify, look carefully at the costs for silver plans available at Pennie while shopping for coverage.

Medicaid. You may qualify for free or low-cost coverage through Medical Assistance (MA) in Pennsylvania if your income is very low.

All subsidies will be automatically calculated when you apply for a plan through Pennie.

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

4. Average premium rates went up for 2023, but that doesn't mean you'll pay more.

Nationwide, the average rate increase for 2023 health plans was about 7.7%. In Pennsylvania, the average number was lower, coming in at an increase of 5.5%. But remember that this number doesn't tell you how much you'll pay for health insurance. Costs vary from insurer to insurer and plan to plan. Also, if premiums for the benchmark plan (the plan used to determine subsidy amounts) go up, subsidies will also go up. This is a long way to say don't let the numbers get you down. Comparison shop at Pennie to find the plans and subsidies available to you.

5. Avoid short-term insurance plans that don’t comply with the ACA.

In 2018, the Trump administration made purchasing short-term insurance plans easier. 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 Medical Assistance (MA) in Pennsylvania.

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

The Biden administration has greatly increased enrollment assistance, 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 Pennsylvania.


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Jurisdictional relevance: ST

There are versions of this article for each State.



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