SIOUX FALLS, SD — A slew of federal funding for subsidized health insurance means South Dakotans could get the “cheapest health insurance options ever” during this year’s open enrollment period. year, according to the Community HealthCare Association of the Dakotas.
Those who enroll in a plan on HealthCare.gov are guaranteed full coverage with no exclusions or add-ons to pre-existing conditions. These plans cover the essential benefits of doctor and hospital visits for prescription drugs and mental health treatment. Registrants also receive free preventive care services, such as vaccinations and health checks.
The Reducing Inflation Act, which passed earlier this year, extended the expanded healthcare tax credits included in the 2021 U.S. Bailout Act. This legislation increased subsidies at all levels for health coverage and extended these subsidies to people making more than 400% of the federal poverty level.
“There are income guidelines, but they’re actually quite generous,” said Jill Kesler, senior program manager at the Community HealthCare Association of the Dakotas, a North and South Dakota nonprofit focused on improving access to health care for rural and disadvantaged populations. -income populations. “And people may think, ‘I have a good job and I make a pretty good living,’ and they don’t qualify. But just to give you an example, for a household of four, you could make up to $111,000 and still potentially receive the tax credits.”
Kesler said four out of five eligible people can find plans for $10 or less a month after tax credits.
Additionally, this open enrollment provides new options for previously unqualified families.
Due to a recent regulatory change, immediate family members of someone with employer-sponsored insurance considered affordable for individual coverage may now be eligible for a market plan.
Prior to the eligibility rule change, dependents of someone with eligible employer coverage faced a “family problem,” where, even though that employer coverage was unaffordable for families, they were excluded from seeking better options in the healthcare market.
“The rule is used to determine if an employer-sponsored coverage offer is affordable, and they were only using the affordability of individual employer-sponsored plans,” Kesler said. “And so why that’s such a huge solution is that they’re looking at whether it’s affordable for the family, not just for the individual employee, so now there will be better access to coverage. family on the market.”
The Kaiser Family Foundation estimated that around 5.1 million people were affected by this interpretation of the rules.
Even for those who already have an insurance plan, Kesler recommended checking out the Health Insurance Exchange to compare rates.
“People should keep in mind that health insurance plans and prices change from year to year,” Kesler said. “If you are enrolled in a 2022 plan, you should return to HealthCare.gov and compare your 2023 plan options to ensure you are getting the best deal available.”
The open enrollment period on HealthCare.gov began November 1 and will end January 15, 2023. For healthcare coverage beginning on the first day of 2023, the enrollment deadline is December 15; otherwise, coverage would begin on February 1.
Certain life changes, such as getting married, having a baby, losing other coverage, or moving, may qualify individuals for a special enrollment period, allowing coverage to be applied for outside of the annual open enrollment period.
To find a qualified professional to help you navigate a potentially confusing registration process, visit www.GetCoveredSouthDakota.org or call 2-1-1.
Jason Harvard is a
Report for America
Corps reporter who writes about state politics in South Dakota. Contact him at
605-301-0496
Where
jharward@forumcomm.com.
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