The End of Open Enrollment: What’s Next?

Posted April, 7 2014 by Amanda


Jessica K., 27, enrolled in health insurance through NY State of Health in February
with the help of a Navigator from Community Service Society

As strange as it seems, the 1st open enrollment period under the ACA has come to an end. The final count of enrollees from NY State of Health is stunning: more than 865,000 New Yorkers enrolled in private and public plans between October 1 and April 1. While some New Yorkers will not have the opportunity to enroll in NY State of Health Coverage until the next open enrollment period on November 15 of this year, hundreds of thousands will still be able to enroll in private and public health insurance plans in the coming months.

This is due to a series of extensions and special enrollment periods, as well as different enrollment rules for public programs such as Medicaid and CHIP. A short guide to these post-open-enrollment opportunities is below.

New Yorkers who are unable to enroll in NY State of Health due to technical glitches will be allowed to complete their applications after March 31.

The Obama administration announced Tuesday, March 25 that individuals who have started their applications before the March 31 deadline but were not able to complete the process before the deadline will have more time to enroll. Shortly after, New York agreed to do the same for those who had made a “good faith” effort to complete their application. These New Yorkers will have until April 15 to finish up.

Domestic violence victims will have until May 31 to apply.

A little known provision in the ACA prevents married couples who file separately from being eligible for premium subsidies. This causes problems for individuals with a barrier to filing for divorce or legal separation, such as domestic violence victims. Last week, the Treasury department announced it would issue guidance that married individuals living apart from their spouse and unable to file a joint return as a result of domestic abuse, will be able to file separately from their spouse and still claim a subsidy. Domestic violence victims will have an extension through May 31 to apply.

New Yorkers may qualify for a special enrollment period to enroll after the deadline.

As with any insurance, there are special circumstances that qualify people to enroll in NY State of Health after the open enrollment deadline has passed. These circumstances are called “qualifying life events,” and they include:

  • Getting married
  • Having, adopting, or placement of a child
  • Permanently moving to a new area that offers different health plan options
  • Losing other health coverage (e.g. due to a job loss, divorce, loss of eligibility for Medicaid/CHIP, expiration of COBRA coverage, a health plan being decertified, aging out of the ACA provision allowing young adults to stay on their parents’ insurance until age 26)
  • For those enrolled in Marketplace coverage, having a change in income or household status that affects eligibility for tax credits or cost-sharing reductions.

There are also more complex cases, which you can learn about here.

New Yorkers eligible for Medicaid and Child Health Plus (CHP) can enroll at anytime of the year.

New York’s Medicaid and CHP programs operate under a policy called “continuous enrollment,” meaning people can enroll at anytime of the year. You can learn more about New York’s Medicaid program here and the CHP program here.

So, while open enrollment has ended, there are still plenty of opportunities for New Yorkers to apply for affordable health coverage through NY State of Health.

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