State-based Affordable Care Act (ACA) public exchange programs and managers of HealthCare.gov appear to be playing a game of COVID-19 special enrollment period chicken.
The administration of President Donald Trump has decided against creating a COVID-19 special enrollment period for HealthCare.gov. Trump said Friday, at a White House press conference, that the government will pay cash directly to hospitals, rather than spending extra to help uninsured people sign up for health coverage through HeatlhCare.gov.
Meanwhile, managers of some state-based ACA public exchange programs are expanding existing COVID-19 special enrollment periods.
Connect for Health Colorado has pushed its COVID-19 special enrollment period to April 30, from April 3.
The Connecticut ACA public exchange program, Access Health CT, has extended its COVID-19 special enrollment period to April 17, from April 2.
Your Health Idaho is the only state-based exchange that has not created a COVID-19 special enrollment period.
Idaho insurance regulators have argued that a special enrollment period is unnecessary in Idaho because two insurers offer “enhanced short-term medical insurance” on a guaranteed-issue basis year-round in Idaho..
The issuers of Idaho’s short-term medical insurance policies can use medical underwriting when setting prices, and they can set an annual benefits maximum as low as $1 million. The tradeoffs are that the policies are often cheaper than unsubsidized ACA-compliant individual major medical insurance, the highest deductible is $2,000, and the highest out-of-pocket maximum is $4,000, even for out-of-network care.
Blue Cross of Idaho says that it will pay for all medically necessary COVID-19 testing without imposing cost-sharing requirements on the patients, and that it will pay for the medical visits needed for the treatment of COVID-19 without cost-sharing until June 30.
The ACA public exchange programs normally use an open enrollment period system, or limits on when people can buy coverage without showing they have what exchange managers think of as a good excuse to be buying coverage, in an effort to persuade healthy people to pay for coverage even when they expect not to be sick.
The ACA exchange rules create many types of special enrollment periods, or opportunities to buy coverage outside of the open enrollment period, including opportunities who have lost their jobs or are facing a substantial decrease in income.
That means new the special enrollment periods at the state-based exchange programs will serve mainly to expand coverage options for people who have been uninsured since the beginning of the year, and possibly to reduce the amount of documentation required of applicants who do qualify for special enrollment periods based on the loss of a job or the loss of income.
— Read ACA Exchanges Programs Rush to Add Covid-19 Enrollment Periods, on ThinkAdvisor.