Affordable Care Act Changes for 2023 and What to Expect in the 2023 Open Enrollment Period

In most countries, the open enrollment period for 2023 health coverage begins on November 1, 2022, through January 15, 2023. You can enroll in, re-enroll in, or change your 2023 health plan through the Health Insurance Marketplace during this period.

Every year the Affordable Care Act (ACA) changes. Between these changes, rising inflation, the increase in health plan options brought by more insurers joining or expanding their presence in the marketplaces, etc., the open enrollment season may be completely different this year.

Knowing what changes to expect and how they will affect your coverage will help you prepare, save money, and ensure you are fully covered and don’t have gaps in coverage.

This guide goes over the changes to expect in the open enrollment period for 2023 health coverage and how they affect you, and gives a few tips to help you navigate this year’s open enrollment period.

Changes to Expect in this Year’s Open Enrollment Period

Several changes are coming in 2023 for the Affordable Care Act (ACA) and this year’s enrollment period. They include:

You may spend more time picking healthcare benefits

Inflation hit 9.1% year-over-year this summer; a 40-year high. The rise has impacted almost all aspects of Americans’ financial decisions, including benefit selections.

study by health and investment firm Voya revealed that 74% of Americans are more stressed about their financial situation because of inflation, and 70% plan to spend more time reviewing their benefit selections to get the best value for their dollar.

Additionally, companies have increased their benefits to attract top hires in the current competition for talent amid a shortage of employees. These changes affect several areas of employee coverage, such as prescription drugs, co-pays, hospitalization, etc. You must carefully compare plans and consider even the smallest changes and differences, as they can impact your bottom line.

The extra step will make the process longer this year, meaning the six additional minutes spent on decision-making in the open enrollment season for 2022 coverage is likely to increase.

You may pay more for healthcare

The Health Insurance Marketplace insurance premiums will increase in 2023. Insurers seek higher premiums because of the increased prices paid to hospitals, doctors, and drug companies.

Some insurers attribute the price increase to the need to recoup the money spent at the peak of COVID-19 and expect hospitals and healthcare providers to raise their costs. They are raising premiums by up to 40%, according to the co-founder and chief executive of Venteur, Stacy Edgar.

Some employers will absorb the extra cost, but others will pass it down to their employees by raising their monthly premiums or out-of-pocket costs.

The US Health Care Plan Cost was $13,020 in 2022, a 3.1% increase from $12,627 in 2021. In 2023, it is expected to increase by 6.5% to more than $13,800.

It will be easier to compare health plans and insurers

A critical change coming in 2023 is the Transparency in Coverage requirements, which aims to equip consumers with enough information to make informed choices.

Starting January 1, 2023, all health plans and insurers will have to publicize price information of 500 common medical items and services. By January 1, 2024, the list will contain all items and services covered by the health plan or insurer.

Additionally, a rating system will be implemented in 2023. The rating system will allow policyholders to rate and review their plans and experiences. Like the typical product reviews, it will be a five-star rating system, with five stars being the best and one star being the worst. If the plan is not rated yet, it will be displayed as a new plan.

The rating system will allow you to view other consumer experiences and make informed decisions off them.

Access to this information will make it easier to compare prices and offerings to pick the best one and to ensure satisfaction.

You will have more options

The increase in the number of insurers and their offerings in the marketplaces has addressed the problem of insurance plans not having enough in-network healthcare providers. This increases the number of options and the likelihood of uninsured consumers enrolling into plans.

Additionally, all insurance plans will be clinically based and not discriminate based on disability, age, medical dependency, life expectance, and other health conditions. This further increases the number of options and their accessibility, especially for specialty services like mental health.

Tips to navigate the open enrollment period 2023

Here are some tips to help you navigate these changes in the open enrollment period 2023 to enjoy their benefits fully.

  • Log in to compare plans and update

In most states, if you don’t log in to update your plan by December 15, 2022, the marketplace may automatically enroll you in the same or a similar 2023 plan. The details are in your insurance company letter, which you should have gotten together with a marketplace letter if you had a 2022 Marketplace insurance plan.

In the open enrollment season for 2022 coverage, 14.2 million consumers signed up for coverage through the marketplaces; 10 million were automatic re-enrollments.

Although it is an option, it can put you at a significant disadvantage, especially now that so many changes exist. For example, you could see an unexpected increase in monthly premiums if the dollar value of tax credit changes due to changes in benchmark plans.

That is why you need to log in to update your application, compare your current plan to 2023 offerings, and check whether you qualify for financial assistance options even if your circumstances haven’t changed.

  • Find out if you qualify for marketplace savings

If you did not take advantage of subsidies when they came online, such as ARPA in 2021, or you have just now qualified, you may be able to save more and pay less for your Marketplace insurance coverage. As you update your application and shop for Marketplace insurance coverage, check if you qualify for a premium tax credit that lowers your premiums.

Doing so could significantly impact your bottom line. According to the 2022 Open Enrollment Report, the average monthly 2022 premium for HealthCare.gov enrollees was $111. It would have been $170, or 53% higher, if it weren’t for ARPA subsidies.

Your tax credit depends on the estimated household income put on your Marketplace application.

  • Watch for gaps in coverage

Focusing on the core workplace benefits, vision, dental, and medical, could leave gaps in coverage. Many employers have added several other benefits to their offerings to attract and retain the best talent, which you should take advantage of.

These benefits include emergency savings support, hospital indemnity insurance, accident insurance, and student loan repayment benefits. They are relatively inexpensive, costing employees less than $5 a week.

Consider every benefit your employer offers to identify and remove all gaps in coverage.

  • Consider employee-offered group life insurance

If you don’t qualify for individual life insurance or can’t afford the high premiums due to inflationary pressures or other factors, you should consider employee-offered group life insurance. It is typically offered as part of a company’s benefits package. There are many benefits to one. They include:

  • They are portable, so you will still be covered if you change employers
  • In many cases, they don’t require a medical exam
  • Spouses and children may also be eligible

The employer holds the master policy in group life insurance, and the employees are certificate holders. However, the coverage limit is usually low, but you can purchase additional insurance.

  • Use available tools and resources

The Voya customer survey also found that seven in ten Americans would like to receive support to help them maximize their benefits across healthcare insurance, retirement savings, health savings accounts, disability insurance, etc.

You can use navigators to understand what is available in terms of plans, coverage, and financial assistance. They are trained enrollment experts, who provide free, unbiased information about the available health plans and everything they need to know about the health insurance exchange.

Navigators also help applicants determine whether they qualify for different plans and subsidies and help them enroll. The recent dramatic increase in Navigator funding will increase their accessibility, among other benefits.

Some employers offer several tools to help you pick the benefits, such as webinars. If they don’t, you can use the free tools and resources on HealthCare.gov to help you make the right insurance coverage decisions.

Navigate the 2023 Open Enrollment Period Successfully

Inflation, policy changes, increase in healthcare benefits, and several other factors have brought changes that affect all current and prospective policyholders, such as an increase in healthcare costs and time spent comparing different options. Understanding how they will affect you will help you successfully navigate the 2023 open enrollment period.

If you want a customized insurance plan that maximizes coverage and makes the most of the new opportunities and benefits, ask a MyHST agent today what options MyHST has and which is the best for your unique situation.

Healthcare Solutions is a wholly-owned subsidiary of the National General Insurance Group and Allstate Insurance Company, so rest assured you’re getting quality service. For more information, contact us today and our teams will be more than willing to help.