State gears up for open enrollment for Md. health insurance exchange

The Maryland Health Benefit Exchange is making it easier for people to see which plans will cost them the least as the exchange on Nov. 1 opens its annual open enrollment period.

Open enrollment will run until Jan. 15, with federal and state funds to reduce health insurance costs for some who do not have access to affordable employer-provided coverage or who do not qualify for Medicaid or Medicare.

In March, Gov. Larry Hogan announced that a record 182,861 people had enrolled through the 2022 open enrollment period, which was extended due to the pandemic.

Michele Eberle, executive director of the Maryland Health Benefit Exchange, said that record high was due to a number of factors, but especially because Maryland’s offerings were some of the most affordable plans in the nation. The state estimates there are still 300,000 people in Maryland who need insurance, so she hopes to reenroll many and reach more.

“We try to make it as easy as possible for people to figure out what’s available to them,” Eberle said.

Premiums are up this year, but with Maryland’s reinsurance program and young adult subsidy, as well as federal expanded tax credits for another three years, rates are still low, she said.

For instance, a 28-year-old Baltimore city resident making about $32,000 a year could be insured for about $20-a-month premium cost. That resident would be eligible for a $17 monthly premium with a gold plan to keep out-of-pocket costs low, she said.

People need to make selections by Dec. 31 in order to make changes or enroll for a plan that starts Jan. 1.

At the exchange’s website, marylandhealthconnection.gov, interested residents can enter basic details into the “Get an Estimate” tool and be presented with the overall lowest-cost plan. In past years, people often chose plans based on the lowest premiums.

This year, the website will help people weigh the value of a cost-sharing reduction if they are eligible. The cost-sharing reduction is available through the federal Affordable Care Act to reduce out-of-pocket costs for eligible enrollees who select silver level plans in the marketplace.

“It’s much better coverage at a lower cost,” Eberle said.

She said two pockets of Maryland’s population can be especially helped by obtaining coverage through the exchange: young adults ages 18-35 and people 55-65 who are self-employed or have retired early but are not yet eligible for Medicare.

This year, more people may be eligible to participate in the exchange. To be eligible, people cannot already have access to affordable health insurance. Under a new rule from the Internal Revenue Service, the definition of affordable employer coverage has been changed to consider if it’s affordable for the whole family — if the price of coverage for the entire household exceeds 9.12% of the household income, as opposed to the price of just an individual’s coverage exceeding 9.12%.

There are also several special enrollment periods throughout the year to reach people who miss out on open enrollment. This includes people who discover they are eligible for the exchange as they file their taxes and check a box for easy enrollment on their state tax return.

And effective July 1, 2022, Marylanders with incomes less than 150% of the federal poverty level ($20,385 for an individual, $41,625 for a family of 4) are able to enroll in a health plan through Maryland Health Connection year-round regardless of enrollment periods, as long as Congress continues enhanced tax credits for this population.

There is no longer a cap on the total household income amount to receive tax credits, so people are eligible for credits if their health care costs exceed 8.5% of total household income.

Previously, those credits were not offered to people who earned more than 400% of the federal poverty level.

Those who are young often don’t feel they need insurance, but Eberle is urging those people to consider it for unplanned medical emergencies, as well as the ability to get vaccines and preventive tests covered.

“We are hoping that people newly insured have now found the value in having that insurance, and so even though their situation may have changed that they will want to continue to have that coverage,” Eberle said.