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Pressure For National COVID-19 Special Enrollment Period Builds

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Managers of more locally run Affordable Care Act (ACA) public exchange programs are adding emergency health insurance enrollment periods, to help people cope with the COVID-19 pneumonia outbreak.

More groups are also calling on managers of, the U.S. Department of Health and Human Services’ multi-state exchange program system, to add COVID-19 special enrollment period (SEP) for the states.

(Related: ACA Exchanges Programs Rush to Add Covid-19 Enrollment Periods)

U.S. health insurers usually restrict when people can buy individual major medical insurance without having a special reason to buying coverage, to keep younger, healthier people to wait until they get sick to pay for coverage.

The ordinary open enrollment period, or time when people can buy individual coverage without having a special reason to be buying coverage, runs from Nov. 1 through Dec. 15 in most of the country.

But many states have started SEPs, to give people who failed to get covered a chance to protect themselves against big COVID-19 health care bills.

California, Colorado, Minnesota and Vermont have now added the list states with COVID-19 SEPs. Consumers who apply for coverage using the SEPs and meet ACA premium tax credit subsidy requirements can get the federal subsidies.

California residents who apply using the Covered California SEP can also get the California tax credit subsidy.


Covered California already had a SEP in place, lasting until April 30, for residents who said they had just learned about a new state subsidy that California is using to help people who earn from 400% to 600% of the federal poverty level for health coverage.

The new California subsidy supplements a federal premium tax credit subsidy that serves only people with income from 100% to 400% of the federal poverty level. The California program helps cut health insurance premium bills for state residents who earn from 400% to 600% of the federal poverty level.

The California “just learned about the new subsidy SEP” runs until April 30.

Covered California announced today that it’s offering a new, COVID-19 SEP, open to “anyone uninsured and eligible to enroll in health care coverage” through June 30.

“All medically necessary screening and testing for COVID-19 are free of charge, and all health plans available through [California Medicaid] and Covered California offer telehealth options,” Covered California said today, in the SEP announcement.

“We want to get as many people covered as possible to ensure they have access to the health care they need,” Peter Lee, Covered California executive director, said in a statement. “Having more people insured is the right thing to do, and this action builds on our efforts to leave no one behind in California.”


Managers of Colorado’s exchange, Connect for Health Colorado, announced a COVID-19 SEP that will last until April 3, with the coverage sold starting April 1.

Connect for Health is encouraging would-be applicants to consider working with “certified enrollment experts,” such as insurance brokers, to get covered.

“Many local experts continue to provide virtual and/or phone appointments,” Connect for Health Colorado says in its SEP announcement.

Applicants who give the reason for buying coverage, ”Will lose or lost health insurance and/or have no other health coverage during the COVID-19 outbreak,” can buy coverage without providing documentation of eligibility for the SEP.


Minnesota’s MNsure exchange today announced that it will offer a COVID-19 emergency SEP running from March 23 through April 21.

For people who enroll from April 1 through April 21, the coverage will have an April 1 start date, MNsure says.

“COVID-19 diagnostic testing is available at no cost for those who are enrolled through MNsure,” the exchange says on its website. “All four medical insurance companies that sell private health insurance plans on MNsure are waiving co-pays, co-insurance and deductibles related to coronavirus disease 2019 (COVID-19) diagnostic testing.”


Managers of Vermont Health Connect today said they’ll offer a one-month COVID-19 emergency SEP for people without health coverage.

The Vermont exchange will also be waiving the financial verifications normally required of people who apply for coverage through the exchange.

To help people with coverage stay covered, exchange plan issuers will extend coverage periods and suspend coverage some types of terminations until the COVID-19 emergency ends. States

Michigan Gov. Gretchen Whitmer, the Democratic governor of a state that uses, asked earlier this week for the Centers for Medicare and Medicaid Services (CMS), the HHS agency that runs, to offer a federal COVID-19 emergency SEP.

New Hampshire Gov. Chris Sununu, a Republican, made a similar request Wednesday.

“Individuals who believe they are demonstrating symptoms of the virus will have greater confidence to get tested and guard against further spread if they know they have a health care plan that will cover them,” Sununu said in a letter to HHS and CMS officials.

The Association for Community Affiliated Plans, a group for 74 plans that provide coverage through government health programs, such as Medicaid, called Thursday for CMS to add a federal COVID-19 emergency SEP.

“We’re already seeing stories of people who are afraid to come forward for testing or treatment because they do not have comprehensive health coverage,” ACAP CEO Margaret Murray said in a statement. “And we’ve seen others where short-term ‘junk plans’ put up barrier after barrier to payment, leaving their customers liable for the bill. A federal SEP will at least give people who hadn’t enrolled in ACA-compliant coverage for 2020 the opportunity to do so.”

CMS should combine the SEP with federal “backstop” help, to protect issuers against the risk that the emergency SEP will bring in a flood of high-cost enrollees, ACAP says.

Today, the Trust for America’s Health, published a package of requests, on behalf of 88 organizations, including Families USA and the National Alliance on Mental Illness, that includes a call for an emergency SEP

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

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