The State of Health Insurance 2023: Has the ACA Changed?

Health insurance may be the last thing you’d expect to be affected by inflation, but medical bills, equipment and services are more expensive than ever, pushing health insurance premiums up in some parts of the country. On average, marketplace health insurance plan premiums are increasing by 4%, according to Healthcare.gov. However, some states are seeing premiums rise by as much as 15% while other states saw premium prices drop by 18%.

The enhanced subsidies in the Inflation Reduction Act lower payments for people who were already eligible for subsidies under the original ACA. If you’re eligible for a subsidy, the premium increases mentioned above won’t affect you. Either way, the best way to find out the price of health insurance offered to you is to compare rates by entering your zip code on this page. Have proof of income handy to see if you’re eligible for 2023 health insurance subsidies.

There have been changes in health insurance since you enrolled in a plan last year. It’s important to understand the new health insurance guidelines for 2023 to set right expectations when choosing the right plan. Here’s what else you should know before buying health insurance this year.

On This Page

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  How Health Insurance Prices Are Changing

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  Which Demographics Are the Most Uninsured?

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  No More “Family Glitch” in 2023

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  Will I Be Automatically Enrolled in My Former Health Insurance Plan?

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  What Is the Maximum Out-of-Pocket Expense Limit in 2023?

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  What Is the Poverty Level in 2023?

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  Important Dates To Remember

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  Can an HSA be used for private health insurance?

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  Private Health Plan Vs Employer Health Plan: Why Would I Pay More?

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  Health Insurance 2023 FAQs

How Health Insurance Prices Are Changing

As you can see in the table below, premiums were highest in 2018, leaving insurers to send rebates to their policyholders. By 2022, rates were adjusted to avoid overtaxing policyholders but some insurers came up short, and we estimate only a small increase in premiums in 2023.

*Bronze plans will also increase by approximately 4%

*Gold plans will only increase by 2%

Get Personalized Health Insurance Quotes Here

Which Demographics Are the Most Uninsured?

• People with a high school education or less
• Hispanics
• Younger adults
• Residents in rural areas
• People without internet access

No More “Family Glitch” in 2023

Last year, if an individual was able to get coverage through an employer, they were eligible for a subsidized plan if the plan cost more than 9.83% of their income. However, when covering family members cost well above 9.83% of their income, there was no assistance. 

In 2023, the affordability of family coverage is based on the worker’s premium contribution for family coverage.

Will I Be Automatically Enrolled in My Former Health Insurance Plan?

In most states you will be automatically enrolled in your old health plan or a similar one if last year’s plan is no longer offered. It is a bad idea to auto renew because you may not get the full subsidy this year. Some may even pay more than they did last year due to changes in the ACA structure. It’s a good idea to compare rates again. You may be eligible for a better plan at a better price.

It’s important to note that if you re-enroll and find out about changes afterwards, you cannot change your plan if it’s past January 15. You’ll have to wait another year to make changes, unless you have a life event that triggers a Special Enrollment Period.

According to a Value Penguin survey, 70% of Americans plan to re-enroll in their health plan, which is a big mistake in terms of getting all the available subsidies this year.

What Is the Maximum Out-of-Pocket Expense Limit in 2023?

The maximum out- of-pocket expense limit will increase from $8,700 in 2022 to $9,100 in 2023. It’s a good idea to look at out-of-pocket cost changes in your plan before you renew. This means that you cannot be charged copays and deductibles once you reach the limit. Your insurer is responsible to pay for all costs thereafter.

What Is the Poverty Level in 2023?

For individuals, the poverty level is $13,590. For a family of four it is $27,750. People with poverty-level incomes may be able to get a subsidized health insurance plan costing $10 or less a month. You don’t have to be at poverty level to get a subsidy, but all premium assistance subsidies are income-based.

Important Dates To Remember

• November 1, 2022: Open Enrollment started. Coverage can start as soon as January 1, 2023.
• December 15, 2022: Last day to enroll in or change plans for coverage to start January 1, 2023.
• January 1, 2023: 2023 coverage starts for those who enroll in or change plans by December 15, 2022 after paying an initial premium.
• January 15, 2023: Last day to enroll in or change a 2023 health plan. After this date, you can enroll in or change plans only if you qualify for a Special Enrollment Period.
• February 1, 2023: Coverage starts for those who enroll in or change plans December 16, 2022 through January 15, 2023 and pay their first premium.

Can an HSA be used for private health insurance?

You cannot use a health savings account (HSA) to pay for private health insurance premiums because it’s not considered a qualified medical expense. However, you can use it for long-term care insurance, COBRA coverage, or health care coverage while you are unemployed. If you are 65 years old or older you can use HSA funds for Medicare premiums and other healthcare coverage.

Private Health Plan Vs Employer Health Plan: Why Would I Pay More?

Some employer health plans are great. Others are the pits. If your health insurance through work covers you, it may not cover dependents or it may cost more to add them than to buy a private plan on your own. Or you may pay more for a better private plan vs buying the one through work that hardly covers any of your needs.

You’ll also have more control over benefits and deductibles if you buy your own health plan. Privacy is another reason people choose to buy their coverage apart from work. They also like the freedom of changing jobs without the hassle of losing their benefits and participating doctors and having to start all over again through another employer plan.

Note that if your employer offers a health insurance stipend instead of coverage, you may be able to apply the stipend to buying a private plan.

Get Personalized Health Insurance Quotes Here

The enhanced subsidies in the Inflation Reduction Act lower payments for people who were already eligible for subsidies under the original ACA.

Whether you are or are not eligible for health insurance subsidies, you should compare all your options, even health insurance plans outside of the marketplace. You can compare rates from hundreds of insurance companies to see who is offering you the best plan at the lowest rates. Just enter your zip code below and answer a brief question to get free quotes from agents in your area.