What’s new for ACA open enrollment: 5 notes

Enhanced premium subsidies, which offset the cost of marketplace coverage for individuals with incomes under 400% of the federal poverty level, are set to continue through the end of 2025. The enhanced subsidies have spurred growth in marketplace enrollment, which reached record levels in 2023.

CMS will implement limits on the number of nonstandard plans insurers can offer in 2024 and add features to the federal marketplace designed to make the shopping process easier for consumers. 

On the federal marketplace, individuals must enroll by Dec. 15 for coverage to take effect at the beginning of 2024. Open enrollment dates can vary in states that operate their own marketplaces. 

Here are five changes to note for 2024: 

1. Insurers will be limited to offering four non-standard plans in 2024, and two non-standard options in 2025. The changes are designed to limit the number of plans enrollees have to sort through. The agency estimates the average enrollee will have 90 plans to choose between for 2024, down from 114 in 2023.
2. The federal marketplace will automatically re-enroll bronze plan members into silver-level plans if they are eligible for higher-level coverage at the same, or lower, premium cost and do not make an active plan selection.
3. The federal marketplace will add new optional questions on enrollees’ sex assigned at birth, sexual orientation and gender identity to analyze health disparities. The marketplace will also include specific cost-sharing information for urgent care and mental health outpatient visits and include a new tool for consumers to estimate total yearly healthcare costs based on their level of utilization.
4. Virginia will transition to a state-based marketplace for 2024. Georgia did not submit its application for a state-based marketplace to be approved in time for the beginning of open enrollment, according to CMS.

5. Marketplace premiums rose slightly in 2024, increasing by an average of 6% and as high as 29% in Virginia. Most enrollees receiving subsidies will not see significantly higher premiums.