What Vermont Residents Need to Know About Obamacare for 2023

Essential facts about the Affordable Care Act (ACA or Obamacare) in Vermont, including whether you must get health insurance, how much it costs, and how you can save money.
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How To Sign Up for Obamacare in Vermont for 2023
Do I Have to Get Health Insurance in Vermont in 2023?

Last Reviewed: Mon, Jan 30, 2023

In Vermont, Affordable Care Act (Obamacare) open enrollment is over, but you may still qualify for 2023 coverage.

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 Vermont:

1. Vermont open enrollment has ended, but you may be able to use a special enrollment period to get covered.

In Vermont, open enrollment for 2023 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 Vermont Health Connect until open enrollment for 2024 begins next fall.

If you’ve lost your job or significant income in the past 60 days, 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 one 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 Vermont 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. And even though Vermont passed a law requiring state residents to have health insurance, lawmakers never agreed on a penalty. That means that if you don’t have health insurance, you won’t face a fee 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 Vermont Health Connect. In 2022, the Inflation Reduction Act extended these more generous subsidies through 2025. Also, Vermont offers state financial assistance to lower-income residents. 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 Vermont Health Connect. 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 Vermont Health Connect 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 Vermont can't earn more than $69,375 and an individual not more than $33,975.) 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 Vermont Health Connect while shopping for coverage.

Vermont cost-sharing reductions and premium subsidies. In addition to the federal subsidies provided under the Affordable Care Act, Vermont offers help with premiums and out-of-pocket costs to those earning up to 300% of the federal poverty level. At Vermont Health Connect, you can find a plan comparison tool to help you figure out if you are eligible for these benefits. To qualify for some types of assistance, you must purchase a silver plan through Vermont Health Connect.

Medicaid. You may qualify for free or low-cost coverage through Green Mountain Care in Vermont if your income is very low.

All subsidies will be automatically calculated when you apply for a plan through Vermont Health Connect.

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

4. Average premium rates went up for 2023, but that doesn't mean everyone is paying more.

Nationwide, the average rate increase for 2023 health plans was about 7.7%. In Vermont, the average number was almost twice that amount, coming in at an increase of 15.2%. 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 Vermont Health Connect to find the plans and subsidies available to you.

5. Vermont limits "short-term insurance plans" to fewer than three months.

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. In Vermont, however, short-term plans must last fewer than three months and cannot be automatically renewed. Vermont plans must also cover pre-existing conditions. (Vermont's Department of Financial Regulation publishes these rules.)

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 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. 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 Medicaid in Vermont.

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 Vermont.



How To Sign Up for Obamacare in Vermont for 2023
Do I Have to Get Health Insurance in Vermont in 2023?

Jurisdictional relevance:

There are versions of this article for each State.

Selected State: Vermont
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