Rapid City, South Dakota
August 15, 2021 is the last day of the 2021 Special Enrollment Period (SEP), which is available in states enrolled in the federal Marketplace through HealthCare.gov. To access the SEP, consumers need to complete an application by August 15 and select a plan within 30 days of completing their application.
Since the start of the SEP on February 15, 2021 more than 1.5 million people have enrolled in health coverage at HealthCare.gov, and as of June 30, 2021, more than 7,200 American Indians and Alaska Natives (AI/AN) have signed up during the 2021 SEP. Additionally, more than 2.5 million current enrollees have returned to the Marketplace to find average savings of over $40 per month on their premiums.
Under the 2021 SEP, eligible consumers who are not currently enrolled in health care coverage have the opportunity to sign up for a plan that best meets their needs. Thanks to the American Rescue Plan Act (ARP), there are many benefits for new and current enrollees. For example, current enrollees may opt to review their health care coverage application, update their information as needed, submit their application, and either select a new plan or reselect their current plan to receive increased savings. New data show that returning consumers can save, on average, 40% off of their monthly premiums because of enhanced tax credits in the ARP. Since the implementation of the tax credits on April 1, 2021, 34% of new and returning consumers have found coverage for $10 or less per month on HealthCare.gov.1
AI/AN consumers who have incomes under 100% generally do not qualify for Advanced Premium Tax Credits (APTC), but could qualify for Medicaid, CHIP, or could still qualify for limited cost-sharing for Marketplace plans. Additionally, under the ARP, households with a tax filer who receive unemployment for at least one week during 2021 can be eligible for APTC even with incomes under 100% FPL, and can qualify for coverage with both increased APTC and zero cost-sharing. So everyone should come back and update their information to see if they can receive increased savings!
For certain eligible enrollees who already had APTC applied to their Marketplace plans, but who did not return to actively update their applications themselves since the ARP benefits first became available in April 2021 (and in July for unemployment compensation recipients), the federal Marketplace automatically updated APTC in early August for these enrollees, with an effective date of September 1, 2021. As such, these enrollees can still return to the Marketplace now to adjust the APTC applied to their plans, and check if they qualify for cost-sharing reductions, the latter of which was not automatically updated by the Marketplace in the ARP redetermination process.
Although members of federally-recognized tribes, Alaska Native Claims Settlement Act (ANCSA) shareholders, and non-tribal members who apply on the same application can qualify for an SEP at any time, and can change plans up to once a month, households with tribal and non-tribal members whose incomes falls below 300% of the federal poverty level should consider enrolling in separate Marketplace plans during the 2021 SEP to get coverage as soon as possible. While current enrollees can update their applications to receive increased savings under the ARP after the close of the 2021 SEP, none-tribal members may be limited in their ability to change plans and tribal members may have to wait longer for their coverage to start.
For example, one potential advantage of the 2021 SEP is that it provides “accelerated” effective dates, so that coverage starts on the first day of the month following plan selection, regardless of which day during the month the applicant selects their plan. In contrast, consumers who select a plan after the 2021 SEP ends and through the AI/AN SEP will have a coverage start date based on the day of the month they select their plan:
Plan selection on or before the 15th of any month will provide coverage that starts on the 1st of the following month. For example, if you select a plan by August 15th, your coverage will activate on September 1st. (Plan selection on or after the 15th of a month will provide coverage that starts on the first of the next following month. For example, if you apply and select a plan on October 16th through the AI/AN SEP, your coverage will start on December 1st.)
If one family member on the application is eligible for the AI/AN SEP, all family members who apply on the same Marketplace application are eligible. This is true even if different family members are eligible for different Marketplace plans due to help with cost sharing that’s based on AI/AN status.
Apply by August 15, 2021! The HealthCare.gov application includes a comparison tool that helps households determine which plans work for them. The tool sorts household members into different enrollment groups based on the household information provided. Applicants then view the plans available for each enrollment group.
About the Great Plains Tribal Chairmen's Association
President Rodney M. Bordeaux is currently serving in his fourth term leading the Rosebud Sioux Tribe. He holds concurrent leadership positions with the Great Plains Tribal Chairmen’s Association, the Great Plains Tribal Leaders Health Board, the National Congress of American Indians, and Dakotans for Health. Mr. Bordeaux received a Bachelor of Arts degree from Augustana College and a Master of Arts from Oglala Lakota College.
About Dakotans for Health
Dakotans for Health, an emerging group of public officials, caregivers, health care advocates, and concerned citizens to improve healthcare in the Dakotas including sponsoring the expansion of Medicaid and defending South Dakota's century old tradition of the initiated measure. We are honored to be joined by Organized Labor, all nine of South Dakota's Native Nations, and AFSCME Council 65 in this worthy endeavor.
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