Delawareans will find more choice in insurers and plans, and continuing enhanced federal subsidies to help with affordability; enrollment runs through Jan. 15, 2023

NEW CASTLE (Nov. 1, 2022) – Coming off a record-breaking year for enrollment on Delaware’s Health Insurance Marketplace, Delawareans seeking coverage for 2023 will find more choice in insurers and plans than ever before, and continue to find enhanced federal subsidies, which began last year under the Biden administration. The subsidies have helped to reduce consumer costs by as much as 40%.

The marketplace’s 10th open enrollment period started today, Nov. 1, and ends Jan. 15, 2023, at www.HealthCare.gov, where consumers can renew existing coverage or sign up for a new plan. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will be effective Jan. 1.

Individuals who don’t act by Jan. 15, 2023, cannot get coverage for 2023 unless they qualify for a Special Enrollment Period based on circumstances such as a loss of qualifying health coverage, change of income, becoming a parent, or other qualifying factors.

This year, Delawareans will have three insurers to choose from vs. only one last year, and a total of 30 plans, the highest total in the 10 years of the marketplace. Insurance Commissioner Trinidad Navarro announced in June that two new insurers – AmeriHealth Caritas (four plans) and Aetna CVS Health (nine plans) – would join Highmark Blue Cross Blue Shield Delaware (17 plan options) in offering coverage on the marketplace for 2023.

In September, Commissioner Navarro announced that Highmark’s rates would increase 5.5% on average. The overall stability of Delaware’s Health Insurance Marketplace reflects continued federal approval of Delaware’s reinsurance program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases.

During last year’s open enrollment, a total of 32,113 Delawareans enrolled for 2022 coverage on Delaware’s Health Insurance Marketplace, an increase of 26.8% over the previous year.

“All Delaware families need access to affordable, quality health care,” said Governor John Carney. “There are more plans to choose from this year, which will help to make coverage even more affordable. I encourage all Delawareans to look through your options, especially small-business owners, independent contractors and individuals who don’t have access to health insurance through an employer. It’s important we prioritize our health.”

In 2021, the Biden administration made expanding access to health insurance and affordability a priority through the American Rescue Plan Act, which increased tax credits and expanded subsidies into the middle class. This year, the passage of the Inflation Reduction Act continued those enhanced benefits through 2025. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,000, compared with $14,300 previously.

In addition, the federal government earlier this month changed the way that the affordability of employer coverage is determined for members of an employee’s family, the so-called “family glitch.” Starting in 2023, family members of a person who is offered employer-based coverage that is “affordable” for the employee only and not the whole family, may be eligible for tax credits on the marketplace for the first time. This change will help more consumers qualify for tax credits and cost-sharing reductions through a marketplace plan.

Federal tax credits are available for those whose household income is between 138% and 400% of the Federal Poverty Level. For 2023 coverage, that’s between $18,754 and $54,360 for an individual, or between $38,295 and $111,000 for a family of four. For coverage in 2022, about 89% of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the monthly premium.

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need care. In a silver plan, the insurer pays about 70% of medical costs and the consumer pays about 30%. Consumers who pick silver health care plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 23% of current enrollees qualified for cost-sharing reductions. For any marketplace plan in 2023, individual consumers can’t pay more than $9,100 in out-of-pocket medical costs and families can’t pay more than $18,200.

For 2023:

• Highmark will offer 17 plans for individuals – three platinum plans, six gold, three silver, four bronze and one catastrophic.
• Aetna CVS Health will offer nine plans – two gold, four silver and three bronze.
• AmeriHealth Caritas will offer four plans – one gold, one silver and two bronze.
• Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 13 stand-alone dental plans on the marketplace, seven with a low actuarial level (pay less monthly, but more when you get dental services) and six with a high actuarial level (pay more monthly, but less when you get dental care).

All plans offer essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric services, birth control and breastfeeding coverage, and COVID-19 vaccines, including the new bivalent booster. In addition, coverage cannot be terminated due to a change in health status, including diagnosis or treatment of COVID-19.

“As we enter the 10th year of open enrollment on Delaware’s Health Insurance Marketplace, we are grateful for the important role that marketplace plans are playing in improving access to high-quality and affordable health care,” said Department of Health and Social Services Secretary Molly Magarik. “And we appreciate the stability that the Biden administration, our congressional delegation, the Insurance Commissioner and our own reinsurance program have all brought to the marketplace. I urge everyone to take another look at the affordability of the plans on Delaware’s Health Insurance Marketplace and look at how the coverage can fit into your family’s budget.”

“Delaware’s Health Insurance Marketplace is more successful than ever before with steady rates, enhanced subsidies, and enrollment at an all-time high,” said Insurance Commissioner Trinidad Navarro. “I am so proud that going into 2023, consumers will also benefit from the most competition our state has seen, with three insurers and 30 plan options to choose from.”

Assistance for Delaware enrollees

Consumers can go to HealthCare.gov or CuidadodeSalud.gov now to explore their options for 2023 coverage, and they can enroll anytime between Nov. 1 and Jan. 15, 2023.

Delawareans who need help enrolling in coverage will have access to free in-person assistance from federally funded and trained specialists at Westside Family Healthcare (statewide) and Quality Insights, Inc., (New Castle and Sussex counties) and by certified application counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown. Westside and Quality Insights each received increased federal funding for navigators to help people enroll for coverage.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge.

For more information, go to www.ChooseHealthDE.com. You can enroll in marketplace coverage at HealthCare.gov or by calling 1-800-318-2596 (TTY: 1-855-889-4325).

According to the U.S. Department of Health and Human Services (HHS):

• About 89% of Delaware’s marketplace enrollees received financial assistance in 2022 to help pay their monthly premiums and/or deductibles and co-pays.
• The overall average monthly premium in Delaware is $706, with the average premium reduced to $169 per month after tax credit. For the 89% of Delawareans who received financial assistance, the average premium after tax credit is $114 per month.
• Among the 32,113 people who signed up during last year’s open enrollment, about 78% were re-enrollees and 22% were new enrollees.
• Financial help is available for individuals with annual incomes up to $54,360; for a family of four the income limit is $111,000.
• About 62% of Delaware’s enrollees signed up during the three weeks before Dec. 15, 2021.

Support from Congressional Delegation

Delaware’s U.S. senators and representative urged uninsured Delawareans to find out what’s available for them on the marketplace.

“I am proud that we were able to extend Affordable Care Act (ACA) subsidies and make health insurance more affordable for Americans through 2025 with the passage of the Inflation Reduction Act,” said U.S. Sen. Tom Carper. “Now in its 10th year, the marketplace is more affordable than ever, and Delawareans have more options than before. I encourage everyone to visit HealthCare.gov or seek free help from our many health insurance navigators and get covered without delay!”

“As we go into the 10th year of open enrollment, it’s clear that the Affordable Care Act has enabled Delawareans to access quality, affordable health insurance through the insurance marketplace,” said U.S. Sen. Chris Coons. “Just this year, my colleagues and I were able to extend critical subsidies for this program through the Inflation Reduction Act to ensure that more families can pay for the health insurance they need without breaking the bank. Starting today, Delawareans have more options than ever before to protect themselves and their families, and they should visit HealthCare.gov to sign up for or change their insurance before January 15.”

“In the wake of the COVID-19 pandemic, access to quality, affordable health insurance has never been more important. That’s why I voted to pass the Inflation Reduction Act in August which extends ACA subsidies, reducing the cost of health care for Delawareans enrolled in health care coverage through Delaware’s Health Insurance Marketplace,” said U.S. Rep. Lisa Blunt Rochester. “And this year, Delawareans have more options than ever before to find an affordable plan that works best for them and their families. I’m glad to join my colleagues – Senator Carper and Senator Coons – as well as Insurance Commissioner Navarro to announce that today, November 1st, marks the beginning of the open enrollment period for Delawareans to sign up for health care coverage through the marketplace. Delawareans have until January 15, 2023, to review their current plans, enroll in a new plan, or get more information at HealthCare.gov. Don’t miss the chance to get covered!”

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans receive coverage under the Medicaid expansion each year. To be screened for or to apply for Medicaid benefits, go to Delaware ASSIST.

Both the Health Insurance Marketplace and the Medicaid expansion have helped to reduce Delaware’s uninsured rate, decreasing from 10% in 2008 to 5.7% in 2021, according to the Census Bureau. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions.