As COVID-19 rages on, California and federal government extend health insurance enrollment

Sacramento Bee (CA)

Jan. 28—Leaders of Covered California have announced they will open a special enrollment period, allowing state residents to continue signing up for health insurance coverage, once the annual open enrollment period ends Jan. 31, the agency's director announced Thursday.

Peter Lee said the decision was influenced by President Joe Biden's executive order opening a special enrollment period in the federal marketplace that signs up consumers for health insurance in 36 states. In the order, Biden authorized a $50 million media blitz to promote the special enrollment period nationally on television, in social media and on websites.

"Across America, people watching their TV's, listening to their radio, on digital, Facebook, will see promotions about enrolling," Lee said. "The last thing we would want is Californians seeing that news, knocking on our doors and being told, 'Sorry, we're not open for business.' It makes sense for our mission. It also makes sense for California consumers to make sure they're not confused."

Make no mistake, though, Lee urged Californians not to put signing up off even one more day to ensure they have coverage starting Monday. Too often, people think they'll do this on the weekend, but when the weekend arrives, they rarely want to spend time looking over insurance options.

Biden, in a statement from the White House, and Lee, in his interview with The Sacramento Bee, both emphasized that the coronavirus disease, known as COVID-19, has caused a national emergency in terms of health care resources. More than 427,000 Americans have died of the disease and more than 25 million have tested positive, according to the U.S. Centers for Disease Control and Prevention.

In California, more than 3.18 million have tested positive for COVID-19 and at least 38,961 have died of the virus, according to California Department of Public Health data updated Thursday. The state reported 737 virus deaths, its second-highest daily total of the pandemic, pushing the average for the past two weeks to a record-high 522 per day.

"Every American has a right to the peace of mind that comes with knowing they have access to affordable, quality health care," Biden's statement read. "Because of the Affordable Care Act, over 100 million people no longer have to worry that an insurance company will deny coverage or charge higher premiums just because they have a pre-existing condition. As we continue to battle COVID-19, it is even more critical that Americans have meaningful access to affordable care."

The Small Business Majority joined other groups in hailing the Biden order, saying: "We're glad President Biden signed new executive orders today that will reopen enrollment on the federal Affordable Care Act marketplaces and strengthen the Medicaid program. This is vitally important to small businesses during this challenging time because more than half of all ACA marketplace enrollees are small business owners, self-employed individuals or small business employees."

Covered California offered a special enrollment period last year as well, Lee said, but this year, the California Department of Managed Health Care and the state Department of Insurance also will be running parallel special enrollments from Feb. 1 to May 15.

"While we can announce a special enrollment for people to come to us," Lee said, "there's about 700,000 to 800,000 people who have insurance in the individual market that go direct to Kaiser, direct to Blue Shield. They're regulated by the Department of Managed Health Care mostly, and some by the Department of Insurance."

Regardless of when they sign up, Californians must sign up and pay their first premium to ensure coverage will start on the first of the next month, Lee said, but insurers will give a grace period if payments arrive on the third of the month.

People who qualify for Medi-Cal can sign up at any time, Lee noted, and their coverage will start right away.

Many Californians are still surprised to learn that they qualify for state subsidies instituted in 2020 to make health insurance more affordable for middle-class consumers, Lee said.

"What I mean by middle class is that a family of four making up to about $150,000 a year could be eligible for financial help," he said. "That's a big deal. Many people think this is only for the poorest of the poor. Not true! The financial help available ranges from free coverage in Medi-Cal for people who are very low-income to, in Covered California, (where) subsidies are bigger the less money that you make."

Lee said he had permission to share a personal anecdote about his own family. He has a nephew who, combined with his partner, brings home a dual-income in the high five figures. The couple, though, are buying a home and have other expenses, so the cost of insurance seemed out of reach.

"They qualify for Covered California," Lee said. "They get financial help, but with that help, it's still a huge struggle for them to afford coverage. They couldn't even think about it without financial help, but ... I'm actually helping them out. I have Leecare as well as Obamacare to help my nephew."

Although a number of states have mounted a legal challenge to the Affordable Care Act that is awaiting a Supreme Court decision, Lee said the case does not loom ominously for him and is not even "a cloud on my horizon." Californians should worry about the impact of that case on their coverage.

"It is so clear from the questions asked by very conservative members of the court that the case brought by, if I may say, a very conservative attorney general (Texas AG Ken Paxton) cherry-picked the most conservative district court judge in the entire nation and then went to a fringe appellant court," Lee said. "Legal analysts say it's bonkers to think the Supreme Court would overturn the entire Affordable Care Act. ... I don't lose a bit of sleep over the Supreme Court case."

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