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At least seven states are now letting any resident who wants health coverage sign up for health coverage.

Any resident in those states who reads about the Covid-19 pneumonia outbreak and feels as if this would be a good time to have health insurance can apply. If the applicants meet the income requirements for the Affordable Care (ACA) premium tax credit subsidy program, they can use the subsidies to pay for coverage.

Resources

  • Connecticut special enrollment period information is available here. (Through April 2)
  • Maryland SEP information is available here. (Through April 15)
  • Massachusetts special enrollment period information is available here. (Through April 25)
  • Nevada special enrollment period information is available here. (Through April 15)
  • New York special enrollment period information is available here. (Through April 15)
  • Rhode Island special enrollment period information is available here. (Through April 15)
  • Washington state special enrollment period information is available here. (Through April 8)
  • An article about the early years of the ACA open enrollment period system is available here.

Seven states — Connecticut, Maryland, Massachusetts, Nevada, New York, Rhode Island and Washington state — are offering the special enrollment periods (SEPs) directly in response to the threat of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19 pneumonia.

In those states, enrollment deadlines range from April 2 through April 25.

California already had a SEP in place, for residents who say they were unaware of a new state health coverage requirements and new state subsidy help. That SEP ends April 30.

The District of Columbia also has had a SEP in place, for residents there who learn about the district’s new health coverage requirements. For taxpayers who file their 2019 income taxes by April 15, the deadline for that SEP is April 15.

The History

Drafters of the ACA created the ACA public exchange system in an effort to create a family of state-run, web-based health insurance supermarkets. The exchange programs were supposed to do for health insurance what Amazon.com had done for book sales.

The ACA eliminated many of the defenses health insurers have used to protect themselves against high claim risk, such as refusals to cover sick people, or moves to make sick people pay more for insurance.

To compensate for the loss of those defenses, insurance regulators, insurers and ACA exchange program managers developed an “open enrollment period” system, or limits on when people can buy health coverage just because they want to have coverage. The idea is to scare healthy people into paying for coverage when they’re healthy, by raising the possibility that they could face devastating bills if they have no coverage and suffer health problems outside of the open enrollment period.

The U.S. Department of Health and Human Services (HHS) runs the HealthCare.gov ACA exchange supermarket for many states.

Some states run their own ACA exchange programs.

In the HealthCare.gov states, the open enrollment period runs from Nov. 1 through Dec. 15.

In all states, people can still sign up for coverage outside the regular open enrollment period if they qualify for a SEP due to a life event such as the loss of employment-based health insurance, or a move to a new state.

HealthCare.gov States

HHS and health insurers could create a Covid-19-inspired open enrollment period for residents of HealthCare.gov states.

Michigan Gov. Gretchen Whitmer, a Democratic governor in a state that uses HealthCare.gov, may be the most visible official who has talked about that possibility.

Whitmer noted that, in the past, HHS has provided health insurance SEPs for residents of Southeastern communities affected by major hurricanes.

“Michiganders need leaders who will do everything they can to ensure quality, affordable care during times like this,” Whitmer said in a statement. “It’s the smart thing to do, and it’s the right thing to do.”

— Read Covid-19 Health Benefits Rule Resources: All 50 States and D.C.on ThinkAdvisor.

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