Episode Summary
The Affordable Care Act (ACA) presents major new opportunities in 2023 for insurance agents to grow their business by helping more families gain health coverage.
Two key policy changes are creating more pathways to enroll previously uninsured Americans through the ACA marketplace all year round, not just during the usual busy 4th quarter enrollment period.
First, the new "family glitch" Special Enrollment Period (SEP) aims to fix an unintended consequence of the original ACA law related to affordability. Before, if an employer's plan was considered affordable for the employee, their family members were ineligible for subsidized ACA coverage. This left many families unable to afford to add dependents to the employer plan or to buy individual plans.
Starting January 1, 2023, the family glitch SEP now allows family members to access subsidized ACA plans, regardless of whether the employee's work plan is deemed affordable. The SEP offers huge potential, with an estimated 5-5.5 million Americans falling into this category. Agents who can reach and assist these families have an enormous prospect pool to draw from all year.
The second major opportunity results from Medicaid redetermination. Beginning April 1st, states will reassess Medicaid eligibility for up to 18 million people who enrolled during the pandemic. The majority are expected to lose Medicaid coverage.
Agents who can connect with and guide these millions losing Medicaid have a prime chance to enroll them into ACA plans. Medicaid redetermination provides an ongoing, year-round SEP for this group. By tapping into community resources, agents can build relationships and a steady pipeline of leads.
Jumping into the ACA marketplace or expanding an existing book of business offers advantages beyond these enrollment opportunities. The market is far less regulated than Medicare - no need to deal with the scope of appointment, call recording, and similar requirements.
The Helpondemand feature on Healthcare.gov also feeds consumer inquiries directly to ACA-certified brokers, providing free lead generation.
With the doors now wide open to enroll millions more into affordable coverage, 2023 is the ideal time for agents to capitalize on the ACA marketplace. Whether you're new or already established in this space, the families who will need expertise navigating their options are out there waiting. Seize the moment and grow your business by helping them gain health and financial security.
Timestamps
(0:00:05) - If you're not working in the ACA right now, you're missing the boat
(0:00:56) - This episode focuses on two new ways you can expand into the ACA this year
(0:01:36) - Gillen: Two new developments under the Affordable Care Act are encouraging enrollment
(0:07:16) - With brokerage bucks, we will reimburse you for marketing
(0:08:46) - Starting on April 1, millions of low-income Medicaid beneficiaries will be redetermined
(0:16:30) - There's an SCP that lets you enroll uninsured people year-round
(0:24:31) - You're building your pipeline for more families when they cross over to Medicare
(0:25:36) - The Brokerage. com helps insurance agents grow their business
