President Joe Biden is preparing to sign an executive order that will create a new, three-month HealthCare.gov special enrollment period.
The executive order also could lead to policy changes at and extra federal support for Affordable Care Act (ACA) commercial health coverage access programs and for states’ Medicaid programs.
White House officials said the president will sign the Medicaid and ACA commercial health coverage access executive order this afternoon, along with a reproductive health care access executive order.
- FACT SHEET: President Biden to Sign Executive Orders Strengthening Americans’ Access to Quality, Affordable Health Care
- HealthCare.gov Increases Same-Store Signups 6.6%
White House officials announced the pending signing of the executive orders in a fact sheet.
The new special enrollment period in the executive order will run from Feb. 15 through May 15, according to the fact sheet.
In the executive order, the president also is asking federal agencies to “reconsider rules and other policies that limit Americans’ access to health care, and consider actions that will protect and strengthen that access.”
The president is asking agencies to re-examine:
- Policies that “undermine the Health Insurance Marketplace or other markets for health insurance.”
- Policies that affect coverage for people with pre-existing conditions, including the after-effects of COVID-19.
- Medicaid work requirements and other demonstration programs or waiver programs that could affect people’s access to Medicaid or ACA exchange plan coverage.
- Policies that may reduce affordability of coverage, including dependent coverage.
“For President Biden, this is personal,” according to the fact sheet. “He believes that every American has a right to the peace of mind that comes with knowing they have access to affordable, quality health care.”
The commercial health insurance provisions in the executive order will be of keen interest to agents and brokers who sell individual health coverage.
Both the ACA exchange plan provisions and the Medicaid provisions will be of interest to health insurers, because many commercial health insurers now provide coverage for people with Medicaid through state managed programs.
HealthCare.gov is a web-based program that helps people shop for commercial individual health coverage and use federal ACA premium tax credit subsidies to pay for the coverage. It’s part of the ACA public exchange system — a collection of web-based supermarkets for health insurance.
Members of Congress created the ACA public exchange system in an effort to improve the individual health insurance market, by giving people an easy way to buy health coverage. Originally, in 2010, when former President Barack Obama signed the two bills in the ACA statutory package, ACA supporters expected states to run their own exchange programs.
Today, 14 states and the District of Columbia run their own ACA exchange programs. The U.S. Department of Health and Human Services (HHS) set up HealthCare.gov to provide exchange program services in the 36 states without locally run exchange programs.
Since Jan. 1, 2014, the ACA has required health insurers to provide individual coverage without considering the enrollee’s individual health status, and without charging more for enrollees with health problems.
ACA public exchange programs have been using an “open enrollment period” system, or limits on when people can buy individual coverage without showing they have a special reason to be buying health coverage. This new order is an effort to push healthy people to pay for coverage — by raising the possibility that, if they fail to pay for coverage, they could need expensive medical care outside the open enrollment period with no way to sign up for coverage.