With open enrollment for the Affordable Care Act marketplace beginning Nov. 1, thousands of Vermonters are about to begin the annual ritual of sifting through coverage options.
It’s an important financial decision for consumers, particularly in Vermont, where the average health care costs are higher than most other states.
A temporary bump in federal subsidies could help Vermonters who buy coverage through Vermont Health Connect get better insurance for less money. Vermont Health Connect, the state’s insurance exchange, covers consumers who can’t get coverage through their employers and don’t qualify for Medicaid or Medicare. In 2021, roughly 24,500 residents enrolled.
But the number of Vermonters who benefit from the beefed-up subsidies could roughly double in 2022 because of higher subsidies through the Biden administration’s American Rescue Plan Act, according to data from the Department of Vermont Health Access. A substantial chunk of them — roughly 18,000 — are uninsured, the department estimates.
Consumers are likely to save an average of $186 per month, but some Vermonters qualify for subsidies totaling hundreds of dollars each month, the federal Department of Health and Human Services estimates.
“If you’ve been told you made too much money for subsidies in the past, it’s worth looking again this year,” said Mike Fisher, chief health care advocate at Vermont Legal Aid.Â
The $1.9 trillion American Rescue Plan Act package also includes subsidies for people who didn’t qualify in previous years.
For example, a single person making $52,000 wouldn't have qualified for assistance in 2020, but in 2022, that same consumer would get $381 a month toward premiums. That’s enough to cover roughly half the monthly cost on a mid-range “Silver” plan, according to Vermont Health Connect’s cost calculator.
For some consumers, particularly those who make less money, the subsidies could cover their entire monthly health insurance payment. A single person with an annual income of $33,000, for example, could qualify for $674 in subsidies. According to the calculator, that’s enough to cover a high-deductible Bronze plan in full.
Rescue Plan subsidies are in effect only for 2021 and 2022, at least for now. Democrats are pushing to extend the beefed-up subsidies as part of the $3.5 trillion budget reconciliation bill that’s winding its way through Congress. If the proposal is approved as written, it would be among the largest expansions in U.S. health care since the Affordable Care Act passed in 2010.
Vermonters who now buy coverage through the Health Connect portal are already benefiting from the subsidies on plans they chose before the Rescue Plan went into effect this year, and that will continue next year even if they don’t sign up for a different plan.
But open enrollment, which runs Nov. 1 to Jan. 15, is the first opportunity for these Vermonters to change their coverage based on the enhanced subsidies, said Sara Teachout, spokesperson for BlueCross BlueShield of Vermont. The larger subsidies could help consumers upgrade their coverage at relatively little cost, she said.
Consumers who didn’t qualify for subsidies in previous years should also head to the Health Connect portal to look at their options, Fisher said. According to the 2018 Vermont Household Health Insurance survey, more than three-quarters of these 18,000 uninsured Vermonters could get significant assistance.
People who don’t sign up “are leaving money on the table,” Fisher said. “And we’re not talking about a few dollars. … It could be as much as $1,000 a month.
The 6,500 Vermonters who bought coverage directly from insurers last year could also qualify for assistance, if they transfer their plan to Vermont Health Connect. Teachout recommends doing so as soon as possible, since subsides for this group go into effect before 2022. These consumers could choose to stay with their existing plan, and also choose to change their coverage for next year during open enrollment, she said.
“Unfortunately every month that you’re not directly enrolled through Health Connect, you can’t apply retroactively,” she added. “You just forfeit the money.”
For more information, visit Vermont Health Connect or call 1-855-899-9600 (TTY: 711). You can also sign up in person, through an assister in your area.