In Rhode Island, Affordable Care Act (Obamacare) open enrollment is over, but you may still qualify for 2022 coverage.
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 Rhode Island:
1. Rhode Island 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 Rhode Island, have enacted laws to replace it. Since January 2020, Rhode Island residents have been required to have health insurance that meets the requirements of the Affordable Care Act or face a state tax penalty, unless they qualify for an exemption.
To learn more about Rhode Island's health insurance requirement and to find out whether you qualify for an exemption, see Do I Have to Get Health Insurance in Rhode Island?
2. Rhode Island open enrollment has ended, but you may be able to use a special enrollment period to get covered.
In Rhode Island, open enrollment for 2022 Affordable Care Act (Obamacare) coverage has ended. This means that, unless you qualify for an exception or your income is low enough for Medicaid, you won't be able to get health insurance through Health Source RI until open enrollment for 2023 begins next fall.
If you’ve lost your job or significant income in the past 60 days, whether due to the COVID-19 pandemic or for any other reason, you might qualify for a special enrollment period (SEP). A SEP allows you to sign up for a new health insurance plan or change your current plan outside the open enrollment window.
In addition to job or income loss, many other qualifying events may make you eligible for a SEP. To learn more, see What Happens If I Missed the Rhode Island Obamacare Enrollment Deadline?
3. You may qualify for new Affordable Care Act subsidies.
Last year, President Biden signed the American Rescue Plan Act (ARPA). The law provides $1.9 trillion of federal aid to Americans struggling with the COVID-19 crisis. The relief measures include additional premium subsidies for those who purchase health insurance through Health Source RI. People who apply for 2022 coverage under a special enrollment period can access these subsidies. (Under the Inflation Reduction Act, the additional subsidies are set to expire at the end of 2025.)
Federal tax credits. Until the passage of ARPA, the ACA provided premium subsidies only to those whose income fell between 100% and 400% of the federal poverty level. For example, the cutoff for a family of four in Rhode Island used to be $104,800. For an individual, it was $51,040.
At least through 2022, no one will have to pay more than 8.5% of their household income for a mid-level plan purchased from Health Source RI. Technically, 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 Health Source RI.
Cost-sharing subsidies. More than half of the people who purchase coverage through Health Source RI receive assistance in the form of 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 2022 health plans, that means a family of four in Rhode Island can't earn more than $65,500 and an individual not more than $25,520.) But they are available only on silver plans. If you think you may qualify, look carefully at costs for the silver plans available at Health Source RI while shopping for coverage.
Medicaid. You may qualify for free or low-cost coverage through Medicaid in Rhode Island if your income is very low.
For more information, see Ways to Save Money on Obamacare in Rhode Island.
4. For 2022, you'll find the same insurers in the Rhode Island marketplace and average premium increases are low.
The Rhode Island Office of the Health Insurance Commissioner held down cost increases for 2022. Blue Cross Blue Shield of Rhode Island requested a 3.1% average increase and was held to just 0.1%. Neighborhood Health Plan of Rhode Island requested an average increase of 8.5% and was approved for just 3.5%. The new premium subsidies discussed above should cover these cost increases (and more) for most people purchasing insurance through Health Source RI.
5. No Insurers Sell Short-Term Plans in Rhode Island.
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. States can make their own rules, however, and the federal changes will have little effect in Rhode Island. The state requires all insurance plans to meet strict standards, including coverage of preexisting conditions and a comprehensive package of benefits. For this reason, no insurers are offering short-term health insurance plans in Rhode Island.
6. You can get help signing up if you need it.
The Biden administration is greatly increasing enrollment assistance plans, 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 Rhode Island.