Open Enrollment for the health insurance marketplace is November 1 to January 15, 2023. For coverage to begin on January 1, enrollment must be completed by midnight on December 15. NASW is a Champion for Coverage and recognizes the importance of social workers who help individuals and families connect to health insurance coverage and health care services.
Health insurance coverage is critical to keeping up with preventive care, addressing physical and mental health conditions, and being protected from unexpected medical costs. During this time of year, individuals and families who do not have health insurance through their employer, Medicare, Medicaid, or other plan, can go to www.healthcare.gov or CuidadodeSalud.gov to find coverage options on the health insurance marketplace that was established through the Affordable Care Act. All plans available on the marketplace provide coverage for the Essential Health Benefits.
For 2023, consumers have more choices and affordable options. The passage of the Inflation Reduction Act allowed the extension of premium tax credits that lower or eliminate out-of-pocket premiums. The Biden-Harris administration recently finalized a rule on the “family glitch” that extends coverage and financial assistance to families that have unaffordable health care coverage with employer-sponsored plans– unaffordable is considered more than 9.5 percent of household income. The administration estimates that this situation affects about 5 million people, and now they will be able to gain affordable coverage on the marketplace because the “family glitch” has been fixed.
The Biden-Harris administration has provided more funding than ever before for Navigator programs that help individuals sign up for coverage through in-person and telephonic assistance. Grant funding of $98.9 million dollars is allowing organizations across the country to support more than 1500 Navigators to provide consumer assistance. Social workers are important liaisons to connect individuals and families with Navigators in their community to provide personalized assistance. Many Navigator programs have expertise in assisting underserved populations including specific racial and ethnic communities, rural communities, LGBTQIA+ individuals, refugee and immigrant communities, low-income families, pregnant women and new mothers, veterans, and small business owners.
Outreach efforts and strategies to keep coverage costs affordable are important tools that are advancing health equity in the United States. A new report shows that since 2020, Black, Latino, American Indian, and Alaska Native consumers saw significant enrollment increases on the marketplace. Social workers should know that their efforts to enroll people in health care coverage help to reduce health disparities.
Social workers can inform clients about available resources to learn more about health insurance coverage options and understand the process to enroll:
- Plan Year 2023 Marketplace Open Enrollment Fact Sheet for more information
- To Find Local Assistance
- CMS From Coverage to Care Enrollment Toolkit
- CMS From Coverage to Care Roadmap to Better Care
- CMS From Coverage to Care My Health Coverage at a Glance
- CMS From Coverage to Care Resources Available in 9 languages
- Georgetown University Center on Health Insurance Reform’s Navigator Resource Guide
- The Value of Health Insurance
- Find Out if Your Income Qualifies You for Savings
Prepared by Carrie Dorn, MPA, LMSW NASW Senior Practice Associate