More Qualifying for Zero Premium Individual Health Insurance

In typical years, you could not enroll in an individual health insurance policy right now unless you experienced a Qualifying Life Event. But 2020 and 2021 are anything but typical years!


As part of the American Rescue Plan Act (ARP), you can enroll in Marketplace health coverage through August 15 due to the coronavirus disease 2019 (COVID-19) emergency. More people than ever before qualify for help paying for health coverage, even those who weren’t eligible in the past. If you qualify for a Special Enrollment Period, due to a life event like losing other coverage, getting married, moving, or having a baby, you can enroll any time.


ARP enhances and expands eligibility for advance payments of premium tax credits (APTCs) to purchase Marketplace insurance coverage under the Affordable Care Act (ACA). The Assistant Secretary for Planning and Evaluation (ASPE) estimates that approximately 3 in 5 (62%) of the 11 million uninsured non-elderly adults eligible for Marketplace coverage in HealthCare.gov states likely can access zero-premium plans, while nearly 3 in 4 (73%) likely can access a plan for $50 or less per month.





Key ARP points include:


  • Under the ARP, the availability of zero-premium plans has increased by nineteen percentage points in this population, and low-premium plans by sixteen percentage points.

  • The ARP substantially increased the availability of low-premium silver and gold plans. Zero-premium gold plan availability also increased.

  • The ARP reduced the expected individual contribution of household income toward benchmark plan premiums to 0% for applicable taxpayers with income between 100-150% of the Federal Poverty Level (FPL).

  • There are approximately two million uninsured adults with incomes of 400% of the FPL or greater in HealthCare.gov states who may be newly eligible for coverage with Marketplace premium tax credits under the ARP.

For more information about “Access to Marketplace Plans with Low Premiums: The Uninsured and the American Rescue Plan,” visit: https://aspe.hhs.gov/pdf-report/access-to-low-premiums-issue-brief-part-II

To read the full Issue Brief, visit: https://aspe.hhs.gov/system/files/pdf/265321/ASPE ACA Low Premium Plans Issue Brief II.pdf

For more information about the Health Insurance Marketplace®1, visit: https://www.healthcare.gov/quick-guide/getting-marketplace-health-insurance/

For more information about the American Rescue Plan and the Health Insurance Marketplace® visit:

https://www.cms.gov/newsroom/fact-sheets/american-rescue-plan-and-marketplace

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