Cowboy Diva asked a good question this morning:
Losing your job is considered a qualifying life event on the ACA exchanges, right? Even if you get offered a replacement (ala COBRA) package by your employer, you don’t need an open season to apply for a healthcare plan on an exchange.
Because that’s the case, for a lot of people suddenly on unemployment, the current administration’s shenanigans about opening ACA don’t make a difference.
Almost but not quite.
Losing your job but not losing insurance as you were already uninsured does not open up a Healthcare.gov Special Enrollment Period (SEP).
Losing health insurance through work is a qualifying life event that opens up a regular SEP on Healthcare.gov.
Losing insurance through work is a life transition. A SEP is always opened up even if you are eligible for COBRA. We’ve talked about the trade-offs between Exchange and COBRA before:
Fundamentally, the question is what are the trade-offs between COBRA and the ACA?
This is a damn good question…
what is the best choice?
The major variables are time of the year, amount of cost sharing left on the COBRA plan, hassle/transition costs, age and eligibility for ACA subsidies.
A 21 year old who has no claims in their work insurance who is COBRA eligible in February and is eligible for big ACA subsidies is likely better off in the ACA individual market as they are likely to see a low to no premium Bronze plan that they are unlikely to use as they are statistically likely to be as healthy as a horse anyways.
A 64 year old who has already maxed out their deductible when they became COBRA eligible in February, makes too much for ACA subsidies and has a knee replacement surgery scheduled in March will likely be better off in COBRA.
If you lost your insurance through work, you can look at the ACA exchanges. There might be a good deal available. At the same time, COBRA may still be attractive if you make too much for ACA subsidies to matter and you anticipate significant medical costs for the rest of the year and have already spent your deductible.
Now if you live in a state (excluding Idaho) that runs its own Exchange/marketplace, you can get a COVID-19 general SEP that applies even if you were uninsured for the first few months of the year. However that is restricted to states that are acively engaged with their own markets.