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Utah Affordable Care Act

Utah Affordable Care Act Comprehensive Guide

In this article, you will learn about the Affordable Care Act health care reform laws in Utah.  You will get an understanding of how the health care law impacts you as a citizen of the state.  Learn how to sign-up for the Affordable Care Act, learn about the Affordable Care Act penalty and subsidies, and much more.

What is Utah Affordable Care Act?

Affordable Care Act, also known as Obama Care, was signed into law in March 2010.  The goal of the Affordable Care Act is to provide US citizens with affordable health insurance and to reduce the cost of health care spending for families and in America.

The Key Points of the Affordable Care Act / Utah Obamacare:

How to Apply for Utah Affordable Care Act?

Utah Affordable Care Act marketplace is run by the Federal government.  Click on HealthCare.gov to access Utah Affordable Care Act Marketplace.  You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.

State Federal or State Marketplace  Website Medicaid Expansion?
Utah Federal www.HealthCare.gov Yes

When can I apply for Utah Affordable Care Act (Utah ACA)?

Utah Affordable Care Act’s Open Enrollment starts on November 1 and ends on December 15.  To have health insurance coverage beginning in the following year, you must apply before the December 15 deadline.

In order to qualify for Tax Credit or Premium Tax Subsidies, you must purchase health insurance from the Affordable Care Act Marketplace during the Open Enrollment period.

If you qualify for Utah Medicaid health insurance, then you can sign-up for Medicaid any time of the year.

When is the deadline for Utah Affordable Care Act (UT ACA)?

Important dates for Utah Affordable Care Act deadlines:  The absolute last day to purchase health insurance from the Marketplace is December 15.

  • November 1: First day to enroll in or change plans for new insurance
  • December 15: Last day to enroll in or change plans for new coverage to start the new year

How much is Utah Affordable Care Act?

There are four different plans within the Utah Affordable Care Act.  The metal plans represent the various levels of coverage you receive and what the plan pays on average.  The plan levels DO NOT represent the quality of the health coverage/doctors you receive.

  • Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
  • Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
  • Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
  • Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost

The cost of the Affordable Care Act in Utah depends on the metal plan you choose and the number of people in the household.   Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.

What are the Utah Affordable Care Act Eligibility Requirements?

In order to get Utah Affordable Care Act, you must meet the following requirements:

  • Must live in Utah
  • Must be a US citizen, national, or lawfully present, immigrant
  • Cannot be currently incarcerated (be in jailed)
  • Have a valid Social Security Number
  • and few other requirements

Do I need to get Utah Affordable Care Act?

Yes, every individual in Utah needs to have health insurance.  The Individual Mandate of Affordable Care Act health care law requires US Citizen to enroll in a health insurance plan or pay a penalty.  If you have Medicaid or company-sponsored health insurance, you have met the insurance coverage requirement.

You can choose not to have health insurance, but you have to pay the penalty in addition to the hospitals/doctor’s medical fee if you do get sick.

How much is the Affordable Care Act Penalty in Utah?

The penalty (or also called individual shared responsibility payment) is calculated in two ways.

Starting in the 2019 tax year, there is no longer a penalty for not having health insurance.

From 2016-2018, the ACA penalty is as follows:

  1. By percentage of income (2.5% of household income or a maximum of National Average Bronze plan premium)
  2. By number of people in the household ($695 per adult, $347.50 per child, or maximum $2085)

You’ll pay whichever penalty is higher. 

How much are Utah ACA Subsidies? What are the requirements?

Affordable Care Act Subsidies are also called, “Premium Tax Credits.”

ACA subsidy lowers your premium – the amount you pay each month to your insurance plan. The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.

In order to qualify for Affordable Care Act Subsidy, your income must be between 100% to 400% of the Federal Poverty Level.

Affordable Care Act - Federal Poverty Level
Federal Poverty Level Insurance Premium After PTC Subsidy
Up to 133% FPL 2% of income
133-150% FPL 3%-4% of income
150-2000% FPL 4%-6.3% of income
200-250% FPL 6.3%-8.05% of income
250-300% FPL 8.05%-9.5% of income
300-400% FPL 9.5 of income
Over 400% FPL No Government Subsidy

Medicaid Expansion under the Affordable Care Act

With the new health care reform, the Federal government offered incentives for states to expand the Medicaid program.  30 states out of the 50 states plus Washington DC expanded Medicaid program while 20 states decided not to expand Medicaid due to expected future cut back funding from the Federal government.

Utah expanded the Medicaid program under the Affordable Care Act Health Care Reform.

State Medicaid Expansion
Utah Yes

Insurance Companies that offer Affordable Care Act Health Insurance Plans in Utah:

The following insurance companies are offering Affordable Care Act Plans in the Marketplace.

  • Altius Health
  • Arches Mutual Health Insurance
  • BridgeSpan Health
  • Humana Medical Plan of Utah
  • Molina Healthcare of Utah, Inc.

Frequently Asked Questions (FAQ) on Utah Affordable Care Act:

  1. Who runs the Utah Affordable Care Act? Federal
  2. Where can I sign up for Utah Affordable Care Act? Click here
  3. Do I need to get health insurance or Affordable Care Act? Yes, if not, you have to pay a penalty.
  4. How much is Utah Affordable Care Act? Click here for the average ACA premium
  5. Did Utah expand Medicaid under the Affordable Care Act? Yes

Click here for more Frequently Asked Questions on Obamacare / Affordable Care Act.

For more information on Utah Obamacare / Affordable Care Act:

Federal HealthCare.Gov Marketplace
Toll-Free: 1-800-318-2596
Website: HealthCare.gov

Utah Insurance Department
State Office Building, Room 3110
Salt Lake City, UT 84114
Health Insurance Division Consumer Service: (801) 538-3077
TDD: (801) 538-3826

If you have a hard time affording health coverage and you have questions about eligibility or current Medicaid benefits, go to:  

Utah Medicaid Program
Utah Department of Health
Division of Medicaid and Health Financing
Street Address:
288 North 1460 West
Salt Lake City, UT 84114

Utah’s five largest cities in terms of population: Salt Lake City, West Valley City, Provo, West Jordan, and Orem.  You can apply for Affordable Care Act Health Insurance in any city in Utah.

Utah Affordable Care Act

Health Insurance Marketplace in Utah

If you live in Utah, you’ll use HealthCare.gov website, to apply for coveragecompare plans, and enroll.  Specific plans and prices will be available on October 1, 2013, when Marketplace open enrollment begins.  Coverage can start as soon as January 1, 2014.

For small businesses and their employees: In Utah, your Small Business Health Options Program (SHOP) is Avenue H. Instead of HealthCare.gov, you’ll use the Avenue H website to apply for coverage, compare plans, and enroll. You can apply as early as October 1, 2013. Visit Avenue H now to learn more.

Beginning Oct 1, the Health Insurance Marketplace will make it easy for Utah residents to compare qualified health plans, get answers to questions, find out if they are eligible for lower costs for private insurance or health programs like Medicaid and the Children’s Health Insurance Program (CHIP), and enroll in health coverage.

By the Numbers: Uninsured Utah residents who are eligible for coverage through the Marketplace. 

  • 359,577 (15%) are uninsured and eligible
  • 289,011 (80%) have a full-time worker in the family
  • 140,864 (39%) are 19-34 years old
  • 243,878 (68%) are White
  • 4,660 (1%) are African American
  • 86,010 (24%) are Latino/Hispanic
  • 9,574 (3%) are Asian American or Pacific Islander
  • 199,708 (56%) are male

332,970 (93%) of Utah’s uninsured and eligible population may qualify for either tax credits to purchase coverage in the Marketplace or for Medicaid if Utah takes advantage of the new opportunity to expand Medicaid coverage under the Affordable Care Act.