What is the Marketplace?

The  public health insurance Marketplace (also referred to as an “Exchange”) is where you can purchase health insurance (also known as Obama Care) for you and your family.  A plan from the marketplace is considered a comprehensive major medical plan and also contains the essential health benefits as established under the ACA law.  When you purchase your health insurance through the marketplace, you are guaranteed issue regardless of any pre-existing condition and you may be eligible for a subsidy (premium tax credit) to help off-set high premiums.

It’s important to know that you can only purchase your health insurance during the annual open enrollment which is November 1, 2019 to December 15^th of each year, or unless you qualify for the special enrollment period.

Is the Marketplace right for you?

Currently, most people are not required to purchase health insurance.  The ACA “shared responsibility payment” and the individual mandate has been eliminated by the Trump Administration for 2019 and beyond.  However, some states have established their own individual mandates, so you still may may be subject to your specific state tax penalty, if any.

If you need comprehensive coverage however, you may consider purchasing an ACA plan, but, without a subsidy, you may not be able to afford it.  Between 2014 and 2017, insurance premiums for Obama Care rose between 99% and 140%.  While premiums for Obama Care have decreased in many states this past year (2019), the lowest cost plan, a bronze plan, is still unaffordable for most people who do not qualify for subsidies.  Studies show that middle income earners, aged 40+, do not qualify for subsidies and pay around 10% of their income for comprehensive health coverage.

For those at or just over the subsidy threshold, costs can be dubious.  Just an additional $5,000 in income (subject to federal and state taxes) results in an additional $1,356 in annual premium for a bronze plan. That zaps up nearly a third of that additional income for premiums.

If you’re not facing a tax penalty, you might want to consider non-ACA health insurance.

Why go without health insurance?  An unexpected illness or accident could wipe you out financially.  In fact, according to a new study 66.5% of all personal bankruptcies that were filed were due to illnesses and accidents leaving individuals unable to work and strapped with medical bills.

Non-ACA alternatives such as Short Term Health Insurance, and/or Critical Care or Hospital Indemnity Plans will cost you about a third of what an unsubsidized major medical plan costs, and will protect your finances so you can focus on your health and getting better, should you have an accident or unexpected illness.