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Washington Obamacare (Affordable Care Act) Facts 2021

What Washington State Residents Need to Know About Obamacare for 2021

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

Updated: 2020-07-16 by

The Affordable Care Act, also known as Obamacare, has not been struck down or repealed. Washington open enrollment for 2021 plans runs from November 1 until January 15.

The news has been full of uncertainty about the future of the Affordable Care Act (Obamacare) as the law once again sits before the U.S. Supreme Court. However, a ruling on that case is still many months away and chaotic political winds could shift and affect the law before that time. For 2021 health plans, you can use Washington Healthplanfinder to compare plans, sign up for coverage, and get financial assistance.

This website provides information about getting health insurance under the ACA, including:

To begin, keep in mind these key points about health insurance in Washington:

1. Open enrollment for 2021 health insurance plans runs from Sunday, November 1, 2020 to Friday, January 15, 2021.

In Washington, you can sign up for 2021 health coverage from November 1 to January 15, 2021. If you enroll by December 15, your coverage will begin on January 1, 2021.

Enrollment for 2020 health coverage has ended, but you can get covered for the rest of the year if you qualify for a special enrollment period, including job loss due to the COVID-19 crisis.

If you are currently uninsured, you can use Washington Healthplanfinder 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 you can continue in the plan you have now, open enrollment lets you review your coverage, compare plans, and switch to a new one if you find a better option.

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

2. For 2021, Washington offers a public option for health insurance in 20 counties.

Beginning in 2021, Washington will be the first state in the country to offer a public option for health insurance, called Cascade Care. In this first year of its implementation, Cascade Care public option plans will be available in only 20 of Washington's 39 counties. (One public option plan will be available in King County, which includes Seattle.)

Washington's public option program looks different from what most people think of as a "public option," because the state doesn't actually provide the insurance. Instead, the state will control the terms and manage the costs, while contracting with private insurance companies to administer the plans themselves.

The new program isn't expected to lead to dramatic savings for consumers but, if it works as expected, it will stem the tide of rising costs.

3. Average premium rates are dropping for the second year in a row and more insurance providers have joined the marketplace.

For 2021, thirteen insurance companies will be offering plans through Washington Healthplanfinder, giving Washingtonians more choice of plans than ever before. Every county will have at least two insurance carriers to choose from. Average premium rates are expected to drop by more than 3% for the second year in a row.

4. Premium subsidies are available to save you money.

Several forms of financial assistance can help you lower your health insurance premiums. In addition to the currently available subsidies listed below, Washington is considering the addition of state premium subsidies for those with income levels up to 500% of the federal poverty level, but these wouldn't begin until 2022.

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 example, for 2021 health plans, a family of four in Washington earning as much as $104,800 can qualify for subsidies, as can an individual who earns up to $51,040. 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 Washington Healthplanfinder.

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 is no more than 250% of the federal poverty level. (For 2021 health plans, that means a family of four in Washington can't earn more than $65,500 and an individual not more than $25,520.) If you think you may qualify, look carefully at costs for the silver plans available at Washington Healthplanfinder while you are shopping for coverage.

Medicaid. If your income is very low, you may qualify for free or low-cost coverage through Apple Health in Washington.

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

5. You won’t face a tax penalty for going without health insurance in 2021—but there are big downsides to being uninsured.

Obamacare’s tax penalty went away in 2019. That means that if you go without health insurance coverage, you won’t have to pay a penalty when you file your federal taxes.

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.) And if you miss open enrollment and find yourself needing coverage mid-year, you may have to wait until 2022 to get it.

6.  Insurers don't sell short-term insurance plans in Washington.

In 2018, the Trump administration made it easier to purchase short-term insurance plans. 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. In Washington, however, short-term health plans are still limited to three months and they are not renewable. Currently, no insurer is offering short-term plans in the state.

Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in Washington.

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

A couple years back, the Trump administration drastically cut funding for  programs that provide help with health insurance enrollment. But that doesn't mean you have to fend for yourself when finding and signing up for health insurance. To connect with local support resources, see How To Sign Up for Obamacare in Washington.

 

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Washington: Law