The Affordable Care Act (ACA) has helped millions of Americans obtain quality, affordable health insurance. It prohibited insurers from denying coverage to people with preexisting conditions and established state and federal exchanges to facilitate this.
It also included penalties for those without health coverage; however, certain aspects vary from state to state.
1. California
Statewide uninsured rates have experienced some of the steepest drops since major parts of the Affordable Care Act or Obamacare became effective in 2014.
Covered California provides affordable health plans through its Affordable Care Act health insurance exchange for California residents. They may access them either during an Open Enrollment period or when experiencing life events that trigger Special Enrollment Periods.
2. Connecticut
Connecticut residents can purchase Affordable Care Act (ACA), commonly known as Obamacare health insurance plans during the annual Open Enrollment period or may qualify for a Special Enrollment Period due to certain life events.
Statewide health insurance exchange and expansion of Medicaid under the Affordable Care Act. Furthermore, legislation has been put into effect that addresses women’s coverage options through mandatory waiting periods and paid leave policies.
3. Delaware
Delaware does not operate its own health insurance exchange but instead partners with the federal marketplace to offer assistance that lowers monthly premiums and out-of-pocket expenses for residents.
Westside Family Healthcare in Wilmington reports the Affordable Care Act is faring well in their region, particularly thanks to reinsurance programs and American Rescue Plans that help keep people covered.
4. Maine
KFF reports that the Affordable Care Act (ACA) removed a “cliff” that existed when family income exceeded 400% of FPL. Furthermore, MAGI reduced maximum income limits for health care subsidies to 138% of FPL.
Some aspects of the Affordable Care Act vary based on where a resident resides, including premium costs and Medicaid eligibility requirements. This guide gives an overview of these differences for residents living in each state.
5. Maryland
Maryland Health Connection opened to accept individual applications on October 1, 2013. Under the Affordable Care Act (ACA), most Marylanders must either obtain health coverage or face penalties.
Most Marylanders receive health coverage either through an employer, Medicare or Medicaid; others purchase insurance through the Affordable Care Act’s (ACA) exchange, which offers plans with various plans and subsidies. Between 2013 and 2016, uninsured Maryland residents declined by 38%.
6. Massachusetts
Mitt Romney, then governor of Massachusetts under Republican governance, implemented universal health coverage in 2006. Under his law implementing this change were both individual and small business mandates and an exchange offering subsidized private policies.
Massachusetts will need to negotiate waivers with the federal government in order to revert back to Romneycare, as these would determine such things as eligibility for federal subsidies.
7. New Hampshire
New Hampshire residents can enroll in Affordable Care Act health insurance during the annual Open Enrollment Period from November 1 to December 15 each year. Plans that comply with ACA are required to cover 10 essential benefits.
Granite State residents can purchase short-term health coverage; however, such policies don’t guarantee to cover ACA’s 10 essential benefits.
New Hampshire boasts lower than national living costs, making the state an appealing location to live and work in.
8. New York
New York fully embraced the Affordable Care Act and operates one of the most robust insurance marketplaces. New York State of Health currently hosts 12 insurers offering individual market plans for 2023 (plan availability varies by county; some plans offer coverage under multiple names).
The New York Health Exchange Marketplace provides financial premium assistance, while permitting young adults to remain on their parents’ plans until age 26. This report explores several strategies that could extend New York’s marketplace coverage while providing estimates on enrollment and cost impacts.
9. Oregon
The Affordable Care Act (ACA) provides health coverage to millions of Americans. It expands Medicaid services, creates state and federal marketplaces, prevents insurers from denying coverage due to preexisting conditions, and requires plans to cover an essential benefits list.
Oregon is taking steps to make health insurance more accessible and affordable for tens of thousands of residents by revisiting a rarely utilized provision of the Affordable Care Act.
10. Rhode Island
Rhode Island requires large businesses with full-time employees to offer them health coverage or incur a penalty fee, while individuals without employer-based plans can purchase affordable health coverage through HealthSource RI during open enrollment.
Many individuals who purchase health insurance through HealthSource RI may qualify for financial help to lower their monthly premium. Furthermore, state law mandates residents have coverage or face a penalty.
