Calif. A.G. Becerra, Stein Send Letter Urging Trump Administration to Instate Special Enrollment Period on Healthcare.gov

SACRAMENTO, California, April 4 -- California Attorney General Xavier Becerra issued the following news release:

California Attorney General Xavier Becerra and North Carolina Attorney General Josh Stein led a coalition of 22 attorneys general in sending a letter to the U.S. Department of Health and Human Services (HHS) and its Centers for Medicare & Medicaid Services (CMS), urging them to reconsider their shortsighted decision to deny a special enrollment period on HealthCare.Gov during the current worldwide pandemic. In the letter, the attorneys general argue that the federal government should take action to make it possible for Americans across the country - who are facing uncertainty as a result of COVID-19 - to obtain the healthcare coverage they need during this critical time.

"As Americans work together to 'flatten the curve' of this global health crisis, our leaders must do all they can to support our communities through this period of physical and economic uncertainty," said Attorney General Becerra. "At a time when millions have lost their jobs as a result of the pandemic, denying people the opportunity to gain healthcare coverage through HealthCare.Gov is not only irresponsible, it's immoral. We're calling on the Trump Administration to do their part so that people across our nation can access affordable, life-saving healthcare treatment. No one should have to choose between taking care of their health and going bankrupt."

In the letter, the attorneys general point out that as a result of the COVID-19 pandemic, millions of individuals have lost their jobs--and with their jobs, their ability to pay for healthcare. Many people may be prevented from obtaining treatment because they lack healthcare coverage, or face financial ruin if they seek care. People working on the front lines in grocery stores, food service, transportation, and sanitation are suffering the brunt of the pandemic as they often lack health insurance and work jobs that do not provide sick leave. Because they are uninsured, they are less likely to have a regular place to obtain healthcare and are more likely to delay obtaining care due to fears of the cost. The Trump Administration has long touted choice and "informed healthcare decisions" as the bedrock of its healthcare policies, but now refuses to give Americans the option of obtaining comprehensive healthcare coverage to combat this unprecedented healthcare care crisis.

The attorneys general also highlight that a national solution to this problem requires federal action. While some states run their own health insurance exchanges and may independently extend enrollment - like Covered California did on March 20, 2020 - 38 states, including North Carolina, rely on HealthCare.Gov to run their exchanges. The federal government has the legal ability to call for a special enrollment period, and must take decisive action so that people in those 38 states can obtain the healthcare they need during this critical time.

Joining Attorneys General Becerra and Stein in sending the letter are the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.

A copy of the letter is available here. (https://www.oag.ca.gov/system/files/attachments/press-docs/CA%20NC%20COVID-19%20healthcare%20exchange%20letter%20plus%20IA.pdf)

* * *

Secretary Alex M. Azar II

U.S. Department of Health and Human Services

200 Independence Avenue, S.W.

Washington, DC 20201

Via Email and U.S. Mail

Administrator Seema Verma

Centers for Medicare & Medicaid Services

7500 Security Boulevard

Baltimore, MD 21244

Via Email and U.S. Mail

RE: Opening Health Insurance Exchanges

Dear Secretary Azar and Administrator Verma:

The undersigned State Attorneys General of North Carolina, California, Colorado, Connecticut, Delaware, the District of Columbia, Hawai'i, Illinois, Iowa, Maryland,Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, and Washington urge the federal government to reconsider its shortsighted decision to deny a special enrollment period on HealthCare.Gov during the current international health crisis. The COVID-19 pandemic is killing people, causing economic upheaval, and stretching our nation's medical resources. Americans continue to experience the economic effects of the virus. Millions of individuals have lost their jobs--and with their jobs, their ability to pay for healthcare. We should not allow the virus to prevent sick people from obtaining treatment because they lack healthcare coverage or to face financial ruin if they seek care. People who lack health insurance are suffering the brunt of the pandemic. They work in grocery stores and food service, they drive trucks and sanitize buildings, and their jobs often do not provide sick leave./1 Because they are uninsured, they are less likely to have a regular place to obtain healthcare and are more likely to delay obtaining care due to fears of the cost./2 The administration has long touted choice and "informed healthcare decisions" to purportedly inform its healthcare policies,/3 but is now denying many Americans the option of obtaining comprehensive healthcare coverage to combat this unprecedented healthcare care crisis.

While tests for the disease are free, treatment may not be./4 And medical bills for uninsured individuals can be in the tens of thousands of dollars./5 Therefore, the COVID-19 pandemic threatens to amplify our national problem of high medical bills, a problem the Affordable Care Act sought to address. But legal and policy solutions are easily at hand by extending the availability of healthcare coverage optionsthrough the federal exchange. Indeed, America's Health Insurance Plans (AHIP) has endorsed a special enrollment period as a measure to address the current healthcare crisis because it would give Americans the "opportunity to get the security and peace of mind that health care coverage provides."/6

A national solution to the problem demands decisive and reasoned federal action. Some states run their own health insurance exchanges and may independently extend enrollment. For example, on March 20, 2020, Covered California announced that enrollment would be extended through the end of June to ensure that all Californians have an opportunity to obtain healthcare coverage./7 But 38states, including North Carolina,rely on HealthCare.Gov to run their exchanges./8 The federal government should take similar action to make it possible for people in those states to obtain the healthcare they needduring this critical time.

Under "exceptional circumstances"--a health crisis unlike any seen in the past hundred years and an economic downturn on pace to exceed the Great Recession--HealthCare.Gov is empowered to provide for a special enrollment period. 45 C.F.R. Sec. 155.420(d)(9). We urge the federal government to thoughtfully acknowledge the current dire circumstances by creating a special enrollment period. We must not allow a lack of insurance to prevent sick people from getting treatment or to bankrupt those who do receive care during these unprecedented times.

Sincerely,

Xavier Becerra

California Attorney General

Josh Stein

North Carolina Attorney General

Phil Weiser

Colorado Attorney General

William Tong

Connecticut Attorney General

Kathleen Jennings

Delaware Attorney General

Karl A. Racine

Attorney General for the District of Columbia

Claire E. Connors

Hawai'i Attorney General

Kwame Raoul

Illinois Attorney General

Brian E. Frosh

Maryland Attorney General

Maura T. Healey

Massachusetts Attorney General

Dana Nessel

Michigan Attorney General

Keith Ellison

Minnesota Attorney General

Aaron D. Ford

Nevada Attorney General

Hector Balderas

New Mexico Attorney General

Letitia James

New York Attorney General

Ellen F. Rosenblum

Oregon Attorney General

Josh Shapiro

Pennsylvania Attorney General

Peter F. Neronha

Rhode Island Attorney General

Thomas J. Donovan, Jr.

Vermont Attorney General

Mark R. Herring

Virginia Attorney General

Bob Ferguson

Washington Attorney General

Tom Miller

Iowa Attorney General

Footnotes:

1. Jennifer Tolbert, "What Issues Will Uninsured People Face with Testing and Treatment for COVID-19?," Kaiser Family Foundation, Mar. 16, 2020, https://www.kff.org/uninsured/fact-sheet/what-issues-will-uninsured-people-face-with-testing-and-treatment-for-covid-19/.

2. Id.

3. See, e.g.,Executive Order 13813, "Promoting Healthcare Choice and Competition Across the United States," 82. Fed. Reg. 48,385 (Oct. 2, 2017).

4. Megan Leonhardt, "Uninsured Americans could be facing nearly $75,000 in medical bills if hospitalized for coronavirus," CNBC, Apr. 1, 2020, https://www.cnbc.com/2020/04/01/covid-19-hospital-bills-could-cost-uninsured-americans-up-to-75000.html; Reed Abelson, "Now That Coronavirus Tests Are Free, Some Insurers Are Waiving Costs for Treatment," New York Times, updated Mar. 31, 2020, https://www.nytimes.com/2020/03/19/health/coronavirus-tests-bills.html.

5. Abigail Abrams, "Total Cost of Her COVID-19 Treatment: $34,927.43," Time, Mar. 19, 2020, https://time.com/5806312/coronavirus-treatment-cost/.

6. Bruce Japsen, "Calls Grow to Open Special Obamacare Sign-Up As Coronavirus Spreads,"Forbes, Mar. 21, 2020, https://www.forbes.com/sites/brucejapsen/2020/03/21/calls-grow-to-open-special-obamacare-sign-up-as-coronavirus-spreads/#fedbb4842c8f.

7. "California Responds to COVID-19 Emergency by Providing Path to Coverage for Millions of Californians," Covered California, Mar. 20, 2020, https://www.coveredca.com/newsroom/news-releases/2020/03/20/california-responds-to-covid-19-emergency-by-providing-path-to-coverage-for-millions-of-californians/.

8. See Kaiser Family Foundation, "State Health Insurance Marketplace Types," 2020, https://www.kff.org/health-reform/state-indicator/state-health-insurance-marketplace-types/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.