Opinion: Trump Should Reconsider ACA Special Enrollment Period
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Basketball and other sports are currently on hold because of the coronavirus outbreak, but the Trump administration still managed to miss a layup last week.
By deciding not to create a special enrollment period for Americans to sign up for health insurance through the federal Affordable Care Act (ACA) exchange, the administration is avoiding a more straightforward path to helping people access health care during what is proving to be the worst global health crisis in a century.
The normal open enrollment period for 2020 coverage began in November 2019 and ended in December. But Trump and his administration have the ability to reopen the federal exchange and remove bureaucratic hurdles while millions of people remain uninsured during a pandemic and unemployment claims are at an all time high.
To be clear, despite the administration's misguided decision last week, many Americans experiencing life-changing events still have the opportunity to turn to the exchanges right now for health insurance options.
"If you [were] employed and had insurance through your employer, and you have lost your job and lost that insurance coming in, now you do have an enrollment period where you can enroll in the individual exchanges for the Affordable Care Act," U.S. Health and Human Services Secretary Alex Azar said, as reported by Politico. "That is existing law."
American workers who have lost their jobs and their health insurance benefit, and who have experienced other qualifying life events that allow for individual special enrollment periods, should explore their existing options. People have 60 days after losing their job-based insurance coverage to demonstrate that they lost coverage and try to find a new plan through the ACA marketplace.
So why then is it necessary to create a more sweeping, universal special ACA enrollment period?
"At this time when health insurance is of critical importance and so many people are experiencing a loss of employment, opening a special enrollment period will cut unnecessary red tape and lift a paperwork burden off individuals who are already facing challenges from a sudden and significant change in circumstances," Arizona's Republican Gov. Doug Ducey wrote in a March 25 letter to the Trump administration.
From a practical standpoint, it would be simpler for people to understand and access health care options if the federal exchange were re-opened to everyone.
Most of the states that run their own exchanges have reopened those marketplaces. Arizona, like Maine, is one of the 32 states that use the federally-facilitated ACA marketplace and thus require federal action right now.
Maine Senate President Troy Jackson and Speaker of the House Sara Gideon led a majority of state legislative Democrats in sending a letter last week urging the federal government to create a special enrollment period, imploring the Trump administration to "help us minimize the impacts on our economy and our health by giving our residents the opportunity to access health care and contain the spread of COVID-19 without fear of incurring medical bills they can least afford at this difficult time."
In a March 22 letter, Gov. Janet Mills requested that Maine's congressional delegation urge the administration to create a special enrollment period "because access to health insurance coverage not only provides peace of mind for individuals, but also protects public health by encouraging the use of necessary health services..."
Following reports that there would not be a special open enrollment period, Sen. Angus King called it "an awful, harmful decision" on Twitter and said the administration should reverse course immediately.
"You shouldn't have to lose your job to be able to buy health care coverage through Healthcare.gov amid a pandemic." Rep. Chellie Pingree tweeted last week, saying the administration's "irresponsible decision" would deter people from seeking COVID-19 testing and treatment.
Rep. Jared Golden's office said he too believes that the ACA marketplace should be open for enrollment during the current crisis.
Last Thursday, Sen. Susan Collins said in an interview with the BDN that she agrees the enrollment period should have been reopened, noting that one of the reasons she pushed for a new small business loan program was to ensure people could remain employed and keep their health insurance.
"There will still be some who lose their health insurance or have difficulty affording it and may want to go on the Affordable Care Act, which has generous subsidies for lower income individuals," Collins told the BDN last week. "So I think reopening the enrollment period makes a lot of sense. And I'm disappointed that the president is not doing that."
The Trump administration made the wrong call on ACA enrollment last week, but the president still can reverse course and do the right thing. The evolving COVID-19 pandemic has quickly dispelled notions of what is set in stone. What seemed impossible one week has quickly become an accepted way of life the next. It's late, but not too late, to listen to the bipartisan chorus of state and federal officials from around the country who have made an effective case for a special enrollment period during the current crisis.
Watch: Nirav Shah on risk
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