ACA Open-Enrollment Opens Again in the Nine States to Broaden Health CoverageMarch 25, 2020
To seek new ways to fight the novel coronavirus pandemic, around nine U.S. States have reopen the open enrollment period, to allow their uninsured residents another opportunity to sign up for a health plan. These states have reopened their health insurance exchanges as an initiative to help ease consumers’ concerns about the healthcare cost and to ensure that they do not deter from seeking medical attention in case of emergency. Generally, it is observed that uninsured patients avoid the required medical care and so there are chances that such people if get infected with the virus are likely to involuntarily spread it.
As per the ACA rules, residents in the U.S. can buy their health insurance policy during the regular open enrollment period that starts from November 1 every year. If they do not buy a health plan during this period and they do not qualify for a special enrollment period, they will not be able to obtain health insurance from the exchange until the next open enrollment period.
The states, which have recently reopened their exchanges are Colorado, Connecticut, Maryland, Massachusetts, Nevada, New York, Rhode Island, and Washington. These states have more flexibility to create a special enrollment period because these states run their own health exchanges. Besides these states, California is another state that announced Friday that its exchange that had been open due to other reasons and will continue to allow its residents to enroll through June because of the turmoil caused by the deadly Coronavirus. Even the District of Columbia is allowing its residents to sign up for the coverage.
Chief Marketing Officer for the Washington Health Benefit Exchange in Washington state, Michael Marchand said that the uninsured residents who don’t get tested for the novel Coronavirus due to the testing and treatment cost would represent an extremely weak link in the response chain and would make things much worse. He says, “The bottom line is, in a pandemic situation, your response will only be as strong as the most vulnerable link in the chain.”
More than 16,000 cases of COVID-19 have been identified in the United States, till Friday 20th March and more than 200 people have died according to Johns Hopkins University researchers.
Around 28 million people in the United States do not have health insurance. In most of these nine states, residents updating their policies or enrolling now will get health insurance coverage effective from April 1.
The 32 states where the federal government runs the health insurance marketplace has not proposed a similar offer. However, twenty-five senators have sent a letter to the Department of Health and Human Services on March 12, and have urged them to provide a special opportunity to consumers, who rely on HealthCare.gov to enroll. In the letter, they have said that “It is imperative for the patients to receive covered care, regardless of whether they test positive or negative for the virus.”
The Centers for Medicare & Medicaid services that runs the federal marketplace in a statement said that they are not coming up with a special enrollment period, but are evaluating options amid the outbreak of the coronavirus.
This will further help people to check whether they qualify for a special enrollment period for other reasons, like a job loss that ends their health coverage.
However, the details of the special enrollment period vary, states like Nevada and Maryland are offering coverage to people without insurance and those with short-term health insurance, as short-term insurance does not offer comprehensive benefits. Whereas states like Massachusetts and Washington allow enrollment for people who have no coverage.
The response as per the officials has been positive. In Rhode Island, around 175 people signed up for a plan within the first 72 hours of the special enrollment period, as per the Lindsay Lang, director of the state’s exchange. In Maryland, more than 1,500 people enrolled in 48 hours as per Michele Eberle, executive director of Maryland’s health exchange. Even Washington has had 2,970 applications and around 530 people enrolled.
The demand for health insurance during the special enrollment period whether due to employment or the virus could pose a financial risk for insurers in these states, as per the Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University. Insurers generally rely on covering a number of people to calculate the amount for health coverage. After they have set prices for plans, it might lead them to pay more to cover the sick than the cost of the plan.
As per the state officials, insurers have been supportive of the move to create a special enrollment period to respond to COVID-19. Nevada state has barred new sign-ups by people to mitigate the risk to insurers but allowed those people, who lost coverage due to not paying for the plan, to directly work with their insurer to resume coverage.
State officials don’t consider reopening the exchanges as rewarding people who ignored regular enrollment efforts but consider offering the uninsured a second chance to get coverage may allow healthier, younger people to buy plans and offset the costs of the sick. However, it will be clear with time only that health or sick will sign up. It is difficult to know people’s reactions now.