Updated: 2021-04-08 by
It's not too late! Affordable Care Act (Obamacare) enrollment is OPEN in Washington until August 15.
Washington has announced a special enrollment period (SEP) for health plan signups under the Affordable Care Act (Obamacare). This COVID-related enrollment period will run through August 15, 2021. It mirrors the federal special enrollment period announced by the Biden administration and it allows all Washingtonians to get covered now.
Also, a new federal law, The American Rescue Plan Act of 2021 (ARPA), increases premium subsidies, provides free health insurance if you’re unemployed in 2021, and waives excess subsidy payments for the 2020 tax year. If you qualify for new financial benefits under ARPA, you can go to Washington Healthplanfinder to sign up.
This website provides information about the new programs available under ARPA as well as other facts 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 Washington:
1. You can use the COVID special enrollment period to get covered under the Affordable Care Act, even though open enrollment is over.
Because of the COVID-19 pandemic, Washington Healthplanfinder will be open for new Obamacare signups until August 15, 2021. This extension of the state's usual open enrollment period allows all Washingtonians to get health coverage and benefit from new financial assistance programs.
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.
As of January 1, 2021, Washington became 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 are 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 controls the terms and manages the costs, while private insurance companies deliver 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. You may qualify for new health insurance premium subsidies.
On March 11, 2021, President Biden signed the American Rescue Plan Act. The law provides $1.9 trillion of federal aid to Americans still struggling with the COVID-19 pandemic. The relief measures include additional premium subsidies for those who purchase health insurance under the Affordable Care Act. Here’s a quick summary of the two types of available subsidies, including updates under ARPA:
Federal tax credits. Until the passage of ARPA, the ACA provided premium subsidies only for those whose income fell between 100% and 400% of the federal poverty level. (For example, the cutoff for a family of four in Washington was $104,800. For an individual, it was $51,040.)
Now, no individual or family will have to pay more than 8.5% of their household income for a mid-level “silver” plan purchased from Washington Healthplanfinder. Even though the amount of the subsidy is based on a silver plan, you can apply the subsidy to any marketplace plan, including bronze, gold, or platinum plans. 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 Washington Healthplanfinder.
Even though Washington is allowing only uninsured people to enroll during the COVID-related enrollment window, you should still be able to switch to a silver plan at Washington Healthplanfinder. That's because becoming eligible for new subsidies is a qualifying event that will allow you to buy or change plans outside of open enrollment. Keep in mind, however, that you have only 60 days to act after you become newly eligible.
These enhanced subsidies are retroactive to the start of 2021, but they're also temporary. They will last only through 2022 unless Congress enacts legislation to extend them.
Cost-sharing subsidies. More than half of the people who purchase coverage through a health insurance exchange receive "cost-sharing reductions" (CSRs). These subsidies 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 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.) Keep in mind that cost-sharing subsidies are available only on silver plans. If you think you may qualify, look carefully at costs for the silver plans available at Washington Healthplanfinder while you are shopping for coverage.
Washington state subsidies. In addition to the currently available subsidies listed above, Washington is considering state premium subsidies for those with income levels up to 500% of the federal poverty level, but these wouldn't begin until 2022.
Medicaid. If your income is very low, you may qualify for free or low-cost coverage through Apple Health in Washington.
In addition to the subsidies described here, keep your eyes out for Colorado state health insurance subsidies that may be coming in 2023.
For more information, see Ways to Save Money on Obamacare in Washington.
4. If you are unemployed in 2021, you qualify for free health insurance.
If you receive unemployment benefits for at least one week in 2021, the American Rescue Plan guarantees that you can receive a mid-level silver plan for 2021 at no cost to you. This is because the law will disregard any income you earn over 133% of the federal poverty level. And that, in turn, will lock in the highest level of premium assistance for you. If you get a job, your eligibility will change. You’ll be able to apply for this benefit when you purchase an insurance plan through Washington Healthplanfinder. Be prepared to prove that you are receiving or have received unemployment compensation this year.
As an alternative, from April through September of 2021, ARPA provides for 100% free coverage under COBRA for those who have been laid off or subject to a reduction of hours great enough to trigger COBRA eligibility. Speak to your former employer about this benefit; for more information about COBRA, see the U.S. Department of Labor website.
5. If you owed excess premium subsidies for 2020, you don’t have to pay.
Did you expect to owe the IRS for excess health insurance premium subsidies you received last year? The American Rescue Plan Act says you don’t have to pay back the money.
If your subsidy assistance fell short of your eligibility, you can still claim the additional amount owed to you when you file your taxes. But if your subsidy amount was too large, you get a free pass this year—and only this year. In other words, don’t underestimate your income when you purchase a 2021 plan because you hope for a similar break next year.
Because this rule is new and tax season is upon us, you may need to call your tax preparer for help. It’s not yet clear, for example, what you should do if you’ve already filed your 2020 tax return and repaid your excess tax credit. If you’re not sure what to do, you can always request an extension to file your taxes, giving you until October 15 to sort it out.
6. 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 didn’t have health insurance coverage in 2020, you won’t have to pay a penalty when you file your taxes this year.
However, 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.)
7. Average premium rates dropped for the second year in a row and more insurance providers have joined the marketplace.
For 2021, thirteen insurance companies are 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 dropped by more than 3% for the second year in a row.
8. 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.
9. You can get help signing up if you need it.
A couple of years back, the Trump administration drastically cut funding for programs that provide help with health insurance enrollment. But the Biden administration is expected to quickly reverse that trend, 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 Washington.
You may also be interested in:
Where to go in Washington to get health plans under the Affordable Care Act (Obamacare) and how to get help with the application process.
Learn whether you must have health coverage under the Affordable Care Act (Obamacare) in Washington.
Learn the five factors that determine what residents of Washington will pay for health insurance under the Affordable Care Act