Skip to content

State Residency and ACA (Obamacare) Health Plans

While the Affordable Care Act (or ACA or “Obamacare”) may be on its last leg or at least subject to a whole lotta change real soon, the signup for 2017 ACA health plans is still going on.

Keep in mind that the following applies to the ACA as it currently is . . .

In one of the online RV forums that I haunt, someone asked what he needed to do to establish residency in Oregon in order to sign up for a ACA health plan in that state.

Some people responded by saying Oregon requires that a person has to reside in the state 6 months, that you’ll need a permanent address, etc, etc.

This is just not true. Furthermore, it’s not true for any state.

State residency requirements are NOT the same as ACA residency requirements.

One more time . . .

State residency requirements are NOT the same as ACA residency requirements.

How do I know? From Recent Guidance About Marketplace Residency Requirement and Special Enrollment Period When Moving (Jan 2016), but the details are spelled out in this ACA Residency FAQ from the Department of Health and Human Services.

The FAQ reads like it was written for RVers. Some FAQ paraphrased excerpts:

Q1: What is the residency requirement for Marketplace coverage?
In order to be eligible for Marketplace coverage, an individual must be a resident of a state (note that it doesn’t say “domicile”)
(1) where he or she is living; and
(2) where he or she “intends to reside” (including without a fixed address)

Q3. What does “intends to reside” mean?
That an applicant has a present intent to reside where he or she is living, and intends to remain in the state where he or she is seeking coverage.
Note that someone visiting a state for a transitory purpose, for example, to obtain medical care, do not meet the residency requirement for Marketplace coverage for the Marketplace service area they are visiting.

Q7. Is there a waiting period before an individual can become a resident?
No, there is no waiting period associated with the residency requirement.

Q8. If an individual moves, does his or her residence change for the purposes of Marketplace coverage?
If an individual moves to a new Exchange service area (i.e. state) and meets the requirements as explained in Question 1 above—with respect to the new location, then the individual will meet the Marketplace residency requirement in the new location.
Enrolled Marketplace consumers must report any and all moves to the Marketplace within 30 days by calling the Marketplace Call Center at 1-800-318-2596.

Q9. Does an individual’s residence change when he or she leaves a state temporarily?
No.

Q11. If an individual travels between homes in different states throughout the year, where is an individual’s residence for the purposes of Marketplace coverage?
If an individual leaves his or her primary home to visit a secondary home for a short duration, the departure will be considered a temporary absence, and the individual will remain a resident of the service area of the primary home. During that time, the individual will not have an “intent to reside” in the location of the secondary home and will not meet the Marketplace residency standard for that location.

In contrast, if an individual has two primary homes where he or she spends time for an entire season or other long period of time, then the individual may live and intend to reside in both locations. In such situations, the individual may establish residency in either or both locations.

Finally, repeat after me:

State residency requirements are NOT the same as ACA residency requirements.

No comments yet

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: