What You Need to Know
- Health insurers say they like the new special enrollment period.
- HealthCare.gov managers are spending about $50 million on outreach.
- Covered California is spending about $6 million.
The administration of President Joe Biden has drafted HealthCare.gov for the fight against the COVID-19 pandemic.
Officials at the Centers for Medicare and Medicaid Services (CMS) brought the web-based supermarket for subsidized private health insurance into full operation, for a new, pandemic-related special enrollment period that’s set to run from Feb. 15 through May 15.
The HealthCare.gov special enrollment period is open both to consumers who want new coverage and those who have already it through HealthCare.gov and want to change their coverage.
Officials estimate that about 9 million uninsured Americans, or those with overly expensive coverage, may be eligible to get an Affordable Care Act (ACA) premium tax credit subsidy support if they sign up for coverage through the special enrollment period.
Biden said Monday, in a statement about the start of the new special enrollment period, that he believes access to health care is a right, not a privilege.
“I will do everything in my power to ensure that all Americans have access to the quality, affordable health care they deserve,” Biden said. “That is especially critical in the midst of a deadly pandemic that has already taken the lives of more than 470,000 of our fellow Americans and infected more than one out of every 12 additional Americans, often with devastating consequences to their health.”
In the past, executives at many commercial health insurers described tight limits on HealthCare.gov enrollment periods as one of their few defenses against ending up with more than their fair share of enrollees with severe health problems.
This time around, America’s Health Insurance Plans (AHIP) is supporting the creation of the COVID-19 special enrollment period.
“That is especially true during a pandemic,” Matt Eyles, AHIP’s president, said in a statement. “We appreciate the Biden administration for providing this additional opportunity for hard-working American families to enroll in coverage for their health and financial security as they continue to fight to overcome the COVID-19 crisis.”
Eyles called the current special enrollment period a “timely and targeted” solution.
Health insurers, state insurance regulators and HealthCare.gov managers originally agreed that the ACA public exchange program would offer coverage to all comers only during a limited “open enrollment period,” in an effort to give young, healthy people an incentive to pay for coverage all year round, even when they felt healthy. In recent years, HealthCare.gov has stated its annual open enrollment periods Nov. 1 and ended the open enrollment periods Dec. 15.
The District of Columbia and most of the states with locally run ACA public exchange programs began by sticking with the HealthCare.gov open enrollment period schedule, then gradually extended their official enrollment deadlines past Dec. 15. Some set the original deadlines as late as Jan. 31.
Outside of the annual open enrollment period, people typically must show they have what regulators believe to be a good excuse to be shopping for health coverage, such as the loss of employment-related coverage, to get covered.
If consumers shopping outside the usual open enrollment period do not qualify for a special enrollment period, they must wait until they next annual open enrollment period to apply for health insurance.
About 12 million people now have health coverage through HealthCare.gov or a locally run ACA public exchange, and about 2 million have individual or family major medical coverage purchased outside the exchange system.
Other people have short-term health insurance, indemnity health insurance, health sharing ministry memberships or other arrangements that are being used as alternatives to major medical coverage.
State Enrollment Period Changes
Now that HealthCare.gov has added an enrollment period on short notice, locally run exchanges have made a wide variety of special enrollment period decisions of their own.
HealthMarkets Inc., for example, is drawing traffic to its private health insurance sales website by posting a state-by-state special enrollment period chart.
At press time, HealthMarkets was showing that, as far as it could tell, exchanges in Nevada, Vermont and Washington state had not added general pandemic-related special enrollment periods.