Switching to an ACA plan after Medicaid

[Rylito]

I recently FIRED and my original plan for health coverage was to sign up for short-term health insurance starting Nov. 1 (when my possible COBRA enrollment period ends) in order to avoid going on Medicaid, as we were originally planning several out of state road trips before the end of the year, and we wanted to ensure out of state coverage in the event of some accident during November and December.

We decided to delay our travel until next year, so I am researching signing up for Medicaid on October 1 after all.  We will have no income through the end of the year, but my income from working this late in the year was high enough to ensure we'd be paying full price on ACA plans this year, so I didn't intend to sign up for ACA coverage until open enrollment, and start that coverage January 1, 2022.  I can manipulate my 2022 MAGI to qualify for a very inexpensive plan.

My question is whether there are any restrictions switching from being on Medicaid (in the very short-term) to an ACA plan?  I know there are for COBRA enrollees and just want to ensure the switch goes smoothly to ensure no gap in coverage.

[seattlecyclone]

ACA subsidies are only available to people who have no other valid health coverage available. Medicaid counts as qualifying coverage here, so my understanding is you need to have your state kick you off of Medicaid before you're eligible for subsidized ACA marketplace insurance.

Normally all it would take to get kicked off is raise your income for a couple months, submit documentation to your state, and they tell you that they won't be covering you through Medicaid anymore. However because we're currently in a "Public Health Emergency" due to the COVID-19 pandemic you may find that your state has temporarily suspended the practice of kicking people off of Medicaid in response to income changes. My state of Washington is doing this. For the time being, once you're on Medicaid in Washington you'll stay on it unless you move out of state or something changes with your citizenship/visa status. Medicaid's weird status as a state/federal hybrid program means that I can't keep track of which aspects of the program carry across nationwide and which vary from state to state, so check in locally whether the Public Health Emergency has the same effect in your location. If it does, you might as well just stick with Medicaid until they stop renewing the Public Health Emergency and use a special enrollment period once you get kicked off Medicaid.

[jim555]

The PHE will last at least through Jan 2022.  No one loses coverage while it is in effect.  Good time to do some Roth conversions while we are in the PHE.  NY locks you in for a year at a time, even if your income goes up your coverage stays until the annual date.