As we approach the ten year anniversary of the Affordable Care Act (ACA), we continue to battle the spread of the novel coronavirus (COVID-19), reminding all of us just how important it is to have health insurance. More than 20 million people have gained health insurance coverage as a result of ACA, according to the Center on Budget and Policy Priorities. Prior to the law being passed, there were certain enrollment barriers. For example, under commercial (non-Medicaid) plans, people with pre-existing conditions weren’t able to get coverage, and if they could, the premiums typically would price them out of the market, anyway. Cost-sharing, tax credits, and rule changes opened up coverage options for many.
However, most of us are not thinking about how the ACA launched a decade ago. We’re thinking about hand washing, not touching our faces, and when life will be able to resume as normal. As we’ve seen in other countries, the numbers of virus cases are likely to increase, even as the nation begins to hunker down and stay home (i.e. it’s going to get worse before it gets better). The Kaiser Family Foundation estimates that there are still 16.7 million people who qualify to shop on the marketplaces, whether state based marketplaces or healthcare.gov, but chose to remain uninsured this past open enrollment season.
One of the options available to states that operate their own health insurance marketplace is the ability to open a special enrollment period to allow uninsured to shop for insurance during the COVID-19 pandemic. States including California, Connecticut, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Washington State, Vermont and Washington D.C. have done just that. We believe these enrollment periods will be not only effective, they are a reminder for the uninsured. New Jersey and Pennsylvania, which are in the process of transitioning to a state-based model, asked the Administrator of the Centers for Medicare & Medicaid Services to authorize a Special Enrollment Period. As of March 31st, according to Politico, this request was denied.
If you’re uninsured and live in one of the above states, or otherwise qualify for a special enrollment period triggered by a life change, consider taking advantage of the open window. If you have questions or concerns, your state exchange is available to help.