During the open enrollment period for 2023 coverage, enrollment reached a record high, with more than 15.7 million  people signing up for coverage through the Marketplaces nationwide.[efn_note]“Effectuated Enrollment: Early 2023 Snapshot and Full Year 2022 Average” CMS.gov, March 15, 2023[/efn_note]
The record-high enrollment was driven in large part by the subsidy enhancements created by the American Rescue Plan (ARP), and those subsidy enhancements will continue to be available in 2024.
For 2024 coverage, there are a few changes that enrollees should keep in mind:
HealthCare.gov’s automatic re-enrollment protocols have changed somewhat,[efn_note]“Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2024” CMS.gov, September 2023[/efn_note] to allow the exchange to move a CSR-eligible enrollee from a Bronze plan to a Silver plan, if the Silver plan would have an equal or lower premium and the same provider network and product type (HMO, PPO, EPO, etc.) as the Bronze plan. This protocol can be used regardless of whether the Bronze plan continues to be available for 2024. The idea behind this change is to maximize the benefits that enrollees can receive, but it’s still in each person’s best interest to log into their account and select their own coverage for 2024. Read why letting your individual health insurance plan automatically renew may not be in your best interests.
In some states,  there are new insurers joining the exchange for 2024. And in other cases, insurers are leaving the exchange for 2024. (For example, Oscar Health is leaving the exchange in California,[efn_note]“Oscar Health will exit from California” Healthcare Dive, May 10, 2023[/efn_note] and Friday Health Plans policies will no longer be in force in any state after the end of August 2023). Insurer exits and entries can result in changing benchmark premiums, which can change premium subsidy amounts. Here’s what you need to know about how that works.
Some states are offering new or enhanced state-funded subsidies for 2024, including California,[efn_note]“Covered California to Launch State-Enhanced Cost-Sharing Reduction Program in 2024 to Improve Health Care Affordability for Enrollees” CoveredCA.com, July 20, 2023[/efn_note] Colorado,[efn_note]“Amended Regulation 4-2-78 – Cost Sharing Reduction Enhancements.pdf” Colorado Division of Insurance, Accessed September 2023[/efn_note] and New Mexico.[efn_note]“2024 Plan Year Health Insurance Marketplace Affordability Program Policy and Procedures Manual” New Mexico Office of Superintendent of Insurance” April 13, 2023[/efn_note] Read more about states that offer their own health insurance subsidies.
Virginia will be using a new exchange platform, instead of HealthCare.gov.[efn_note]“State-based Exchanges” CMS.gov, Sept. 6, 2023[/efn_note] (Georgia had also sought approval to operate its own state-based exchange platform, but CMS delayed Georgia’s implementation until the fall of 2024.[efn_note]“CMS letter to Georgia Access” CMS.gov, July 27, 2023[/efn_note]
The Biden administration has proposed a rule change that would allow DACA recipients to be able to enroll in coverage through the exchanges starting November 1, 2023.[efn_note]“Clarifying Eligibility for a Qualified Health Plan Through an Exchange, Advance Payments of the Premium Tax Credit, Cost-Sharing Reductions, a Basic Health Program, and for Some Medicaid and Children’s Health Insurance Programs” Federal Register, April 26, 2023[/efn_note]